HomeMy WebLinkAboutFulp Applicationlf
Citizen boards and commissions are critical to the effective functioning of County government.
We appreciate your interest in wishing to serve Kittitas County and ask that you complete this
brief application, if you wish, please feel free to attach a fact sheet or resume to this application.
This application form is considered a public document & is subject to Public Disclosure.
PLEASE PRINT CLEARLY.
BOARDS OR COMMISSIONS FOR WHICH YOU WOULD LME TO BE CONSIDERED:
•
Behavioral Health and Recovery Advisory Board
3
• List any specific seat you are interested in as well as the District you reside in.
Date: 06/15/2018
Name: Doug Fulp
Business Address: 400 E University Way Home Address: 707 Cypress Ct
MS 7489
Ellensburg, WA 98926 _ Ellensburg, WA 98926
City State Zip City State ! Zip
Contact Number: 509-963-3213 253-230-1417
Email address:._���[�115.Ridlll4illcll.�Rti]
Education: (High school, name and location of college or university, year graduated, and degree):
Henry Foss Hiq_h School, Tacoma WA; Central Washington Uniyersit}G, Ellensburg WA, 2095,
Information Technology and Administrative Management; Montana State University, Bozeman,
MT, 2010, Master of Adult and Higher Education.
Current Employment: (job title, employer, employment date, contact, phone):
Assistant Director. Collegiate Recovery. Alcohol & Other Druq Programs and Services, Central
Washin ton Unwersity Wellness Center October 2013 -Present Supervisor Marissa Howat
Director, 509-963-3213
PLEASE NOTE: ALL APPLICATIONS SUBMITTED TO THE BOARD OF COUNTY
COMMISSIONERS FOR APPOINTMENT BECOME OFFICIAL PUBLIC RECORDS.
Special reasons for wishing to serve on the Board or Commission:
I have worked in the field of substance use for 10 years and the field of recovery the past 2
ears as the coordinator of the Recovea Outreach Community at Central Washington
University. I have a passion for educating people on the risks associated with substance use
and helping those with substance use disorders, Though other community needs arise,
alcohol still remains one of the tap public _health _issue facing our county.
What advisory panels, Boards/Commissions have you previously served on?
Chair - Kittitas County Community Network and Coalition - 3 years__
Board Member - Kittitas County Community Network - 2 years
Please list any training or experience you have that would be beneficial to serving on the Board or
Commission: Prime for Life 20 hour Alcohol Education Course certified instructor,
Are you available to attend board meetings during the day or evening M -F?
If no, please explain: Yes, with notice
Please furnish two references who could speak to your qualifications for the desired appointment:
i
Name: Joy Stohosky_ Phone: (H)
w') 509-963-1515
Address: 400 East University Way City: Ellensburg .state: WA Zip: 98926
• Name: Crvstal Church
Phone: (H) (V) 509-962-2737
Address: -Ij�_'° t 611 UL-CXv4v1'0&°•5^2.3VV_1W4Am" City Ellensburg State: WA Zip: 98926
Your application will be placed with others interested in serving on the same board or commission.
When a vacancy occurs on the Board/Commission in which you have indicated an interest, the
Board of County Commissioners may desire to conduct an interview. We will retain your
application for 2 years from the date it is received.
YOUR SIGNATURE:
Please return completed form to-
Date: G/M In/"/9-
Board
Board of Kittitas County
Commissioners 205 W.5th, Room 108
Ellensburg, WA 98926
509.962.7508 or bocc@co.kittitas.wa.us
PLEASE NOTE: ALL APPLICATIONS SUBMITTED TO THE BOARD OF COUNTY
COMMISSIONERS FOR APPOINTMENT BECOME OFFICIAL PUBLIC RECORDS.