
The image depicts a blank form titled "Board Member Resume" for the St. Joseph State Hospital Advisory Board in St. Joseph, Missouri. The form is designed to gather personal and professional information from prospective board members. It contains numbered sections for the individual's name, occupation, current and past board or committee memberships, and details of any volunteer capacities or projects they have participated in that are not included in the committee or board memberships section. There are ample spaces provided for detailed responses. Additionally, the bottom of the form includes identification codes and a date, indicating it was created in July 1982.