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10 <br />Page 1 of 1 <br />Richard Gross <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 />Mr Richard Gross <br />3006 Joshua Dr <br />Hillsborough NC 27278 <br />644-0157 <br />same <br />na <br />na <br />retired <br />2002 <br />Eno <br />Male <br />Caucasian <br />Boards/Commissions applied for: <br />Adult Care Home Community Advisory Committee <br />Work Experience: <br />Geriatric Social Worker witn ABC Corp, Bloomfield IA 53501 (Davis County) <br />Nursing Home Care Review Board in Wapello County <br />Volunteer Experience: <br />Lion's Club, Habitat for Humanity, Master Gardener (Iowa) <br />Hillsborough Civitan, RSVP Volunteer with Seymour Center Garden Group <br />Education: <br />AA Liberal Arts, Indian Hills Community College, IA <br />BA Psychology and Human Services, Buena Vista Univ, Ottuma, IA <br />Postgraduate study gerontology, 35 hours, Buena Vista Univ <br />Other Comments: <br />Learned of this through the RSVP Volunteer Program Enjoy people. STAFF <br />COMMENTS: Originally applied for Adult Care Home Community Advisory Committee <br />2/11/2009. ADDRESS VERIFICATION: 3006 Joshua Dr. Hillsborough is Eno township <br />OC jurisdiction. <br />This application was current on: 2/11/2009 12:40:26 PM Date Printed: 9!24/2009 <br />