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2017 PIT INTERACTIVE
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Executive Council Membership Application
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Indicates required field
Name
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First
Last
Enter your name or the name of the member of your organization that will be attending TCCoC Meetings on behalf of your organization.
Title
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Organizational Affiliation
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Enter the name of the organization that would like to participate in the TCCoC.
Email Address
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Phone Number
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Mailing Address
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Line 1
Line 2
City
State
Zip Code
Country
Please indicate which of the following describes you (check all that apply):
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Formerly or Currently Homeless Person
Housing Assistance Provider
Mainstream Assistance Provider (stabilization or basic needs services other than housing available to individuals and/or families experiencing homelessness)
Emergency Solutions Grant (ESG) Program Recipient Organization Representative
CoC-Funded Provider Representative
Continuum of Care General Collaborative Chairperson
Homeless Subpopulation Service Provider Representative (please desribe below)
Representative of Local Government and/or mainstream assistance provider
Public Policy representative
If applicable, describe the homeless subpopulation to which you provide services:
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Please describe your experience and current role in addressing homelessness in Tehama County:
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Code of Conduct
Tehama County Continuum of Care Executive Council recognizes that members represent interests of organizations who may ultimately receive benefits from the CoC Program. To ensure that individuals and organizations that best serve the needs of the community will not be denied funds because of their active participation on Tehama County Continuum of Care Executive Council, and to confirm that members serve the needs of the community and not the interests of any organization or entity, conflicts of interest will be clearly stated after introduction of the agenda item. Conflicts may also be stated prior to voting if Tehama County Continuum of Care Executive Council feels it is necessary.
No member shall vote upon or participate in the discussion of any matter, which shall have direct financial bearing on the organizations the member represents. Conflict of interest and even the appearance of a conflict of interest must be avoided. Members shall report conflict of interest and recuse themselves from voting on issues where a conflict of interest is apparent or identified.
No member should vote on a question in which he or she has a direct personal or pecuniary interest not common to other members of the organization. A conflict of interest is any situation in which financial or other personal considerations may unduly influence Executive Council judgment.
Recusal Procedure:
In any case in which an Executive Council member has a personal interest in the outcome of the vote (an interest not shared by other board members), the interested board member should
leave the meeting room
so the remaining directors can freely discuss and vote on the issue. (California's
Fair Political Practices Act
, Calif. Code of Reg. §18702.5.) Once the vote is taken, the recused director may return to the meeting.
I understand that by submitting this application, I agree to observe the Tehama County Continuum of Care Executive Council Code of Conduct and Recusal Procedure.
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I agree
Submit
