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11 <br />Page 1 of 1 <br />Michael Carstens <br />Volunteer Application <br />Orange County Advisory Boards and Commissions <br />Name: <br />Name Called: <br />Home Address: <br />Phone: (Day) <br />Phone: (Evening) <br />Fax: <br />Email: <br />Place of Employment: <br />Job Title: <br />Year of OC Residence: <br />Township of Residence: <br />Zone of Residence: <br />Sex: <br />Ethnic Background: <br />Date of Birth: <br />Dr. Michael Carstens <br />108 Carriage Circle <br />Chapel Hill NC 27514 <br />919-968-4774 <br />857-498-1442 <br />919-942-5291 <br />carstensmike@hotmail.com <br />Chapel Hill Eyecare <br />Optometrist <br />2005 <br />Chapel Hill <br />Male <br />Caucasian <br />8/8/1977 <br />Boards/Commissions applied for: <br />Board of Health <br />Work Experience: <br />Practicing otpometrist for last 6 yrs. Chapel Hill Eyecare Optometrist since January 2005. <br />Volunteer Experience: <br />Bear Hug Foundation, medical mission to EI Salvador, October 2004 <br />Volunteer Lecturer for Chronic Disease Collaborative symposium, chapel hill 2005-6 <br />Education: <br />University of Maine @ Orono, 1995-1999 <br />New England College of Optometry 1999-2003 <br />VAMC -Baltimore, Residency in Hospital Based Optometry and Ocular Disease 2003- <br />2004 <br />Other Comments: <br />STAFF COMMENTS: Originally applied for Board of Health 3/30/2009. ADDRESS <br />VERIFICATION: 108 Carriage Circle, Chapel Hill is Chapel Hill township, CH jurisdiction. <br />This application was current on: 3/30/2009 11:57:14 AM Date Printed: 7/31/2009 <br />