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2. The Health and Wellness Committee's role is to address physical and mental health, emergency preparedness, personal wellness, food and housing access issues, etc. for the residents of the City of North Salt Lake

4. Contact Information
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Phone Number*
18. Email Address
20. Please explain why you are interested in serving as a member of the Health & Wellness Committee.
22. Please describe any professional or volunteer experience you have in any of the following areas: physical and mental health, emergency preparedness, personal wellness, food and housing access, addiction services or any other activities related to public health and general welfare.
24. What do you think are the greatest health and wellness challenges currently facing NSL residents?
26. Of all of the areas of proposed Committee work areas, which one interests you the most?
28. Do you have any experience in marketing, branding, communications or public outreach and education? If so, please describe:
30. Thank you for your application. If you have questions related to this application or committee, please contact Linda Horrocks at lindah@nslcity.org.
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32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit Submit and Print

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