The Township of Schaumburg Mental Health Board (MHB) was established in 2022 following the passing of a local ballot referendum. The MHB oversees an annual levy to provide services related to mental health, developmental disabilities, substance abuse and addiction (MHB Service Areas).

The Township Board of Elected Officials appoint the nine-member Board of Directors to administer the levy funds, ensuring services to Township residents. As mandated by the Illinois Community Mental Health Act (405 ILCS 20, et al.), the MHB is required to do the following as they relate to MHB Service Areas:

·        Identify the needs within the Township.

·        Consult agencies providing local services.

·        Disburse annually collected tax fund on direct services.

·        Submit a written plan and annual reporting for community services.

·        Meet at least quarterly to execute the functions of the Board.


Mental Health Board Application

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Applicant Information

Name*
Address*
Have you worked for Township of Schaumburg before?*
Do you have any relatives currently employed by Township of Schaumburg or any political sub-division thereof?*
Have you ever been convicted of or charged with a felony or misdemeanor? (A conviction will not automatically disqualify you from an appointment; exclude minor traffic violations)*
Are there any felony/misdemeanor charges pending against you?*

Employment History

Your work experience is an important factor in evaluating your qualifications. Please list your current employer or most recent employer.
Employer's Address:
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From
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To

Public/Civic Leadership Information

Do you or any of your close family or business connections make use of services provided by, or connected with, the elected office or board/commission for which you are applying?*
Do you or any of your close family or business connections serve in any elected office, on any board/commission, or with any organization which has or may have any connection or relationship with the elected office or board/commission for which you are applying?*


References

Please give the names of three persons, not related to you, whom you have known for over one year.
Reference 1:
Reference 2:
Reference 3:

Education & Life Experience

Are you currently or have you previously served as an elected official, served in a government commission, or private organization?*

Certification & Release - Read Carefully

Untitled*
I certify that the answers and information given by me in this application are true, correct and complete without qualification. I understand the Township has the right to refuse to appoint me or immediately discharge me, at any time if it discovers I have provided incomplete, untrue, or misleading answers or information in this application or on any other documents or forms submitted at any time during my employment. I authorize the Township and its agents, to verify the answers and information given by me in this application and to make any investigation of my background deemed necessary. I authorize former employers, law enforcement organizations, educational institutions, and any other third party contacted by the Township or its representatives, to release to the Township or its agents information which may be used to verify information in this application.