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6 <br />Page ~ of ~ ~ Peggy Cohn <br />Volunteer Application <br />Orange County Advisory Boards and Commissions <br />Name: <br />Name Called: <br />Home Address: <br />Phone: ~DaY~ <br />Phonew ~EvenMng~ <br />Fax: <br />Email: <br />Place of Ernployment: <br />Job Title: <br />Year of CSC Residence: <br />Ms. Peggy Cohn <br />Peggy <br />~ a Bays~vater Place <br />Chape[ Hill NC 2?"51 ? <br />919489-5624 <br />SaC~e <br />peggycohn a~earthlink.net <br />retired <br />Geriatric Care Manager <br />Tov~nship of Residence: Chapel Hill <br />~o~ne of Residence: C.H. City Limits <br />Sex: Female <br />Ethnic Background: Caucasian <br />Date of Birthw 8l281~ 938 <br />BoardslCommissions applied for: <br />'V~ork Experience <br />Community Health Nursing educator UNC and Penn State University <br />Director of Family Ties, Geriatric Care Management, State College PA <br />Volunteer Experience: <br />Nursing Home visitation <br />Nan profit Boards in PA <br />Education: <br />BA, r~ellesley . <br />BSN, Columbia University <br />MPH, UNC <br />PhD, Penn State University Cal[ege of Health and Human Deve[opmenet <br />Other Comments: <br />STAFF COMMENTS: Originally applied for Adult Care Home Community Advisory <br />Committee and NHCAC and Adv. Board an Aging 1 fl11412a05. ADDRESS <br />VER1FlCATION. [wiling address [fisted above. Residence is 233 McCauley Street in <br />Chape[ Hill city limits. <br />This application was current on: ~ Old 012005 ~ ;34:2 AM Qate Printed: 313012009 <br />