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Sussex County HSAC Membership Application

Sussex County Human Services Advisory Council Membership Application

The Human Services Advisory Board seeks members with diverse backgrounds and experiences in order to identify, examine, recommend, plan and advocate for human services in the county. Active participation on a committee is required in addition to the monthly Board meetings.

For any questions, please contact Marissa DeOliveira at MDeOliveira@sussex.nj.us.

Phone Number

Length of Residency in Sussex County

Occupational Background

Educational Background

Why do you want to serve on the Human Services Advisory Council?

Please describe any special skills, experiences, advocacy, etc., you could contribute to the Advisory Board.

Community Involvement/Affiliations (This can include offices held, other boards, volunteer activities, etc.)

Would your service on this board present a conflict of interest with any other organization with which you are involved? (If yes, please explain.)

List any ideas or suggestions you have for issues to be addressed by the board and any current projects you are interested in working on.

When would you be available to join, if appointed?

When would you be available for a personal interview?

Please upload a copy of your resume and letter of intent.

A copy of your responses will be emailed to the address you provided.

Sussex County Human Services Advisory Council Membership Application

Full Name

Full Address

When would you be available for a personal interview?

Please upload a copy of your resume and letter of intent.