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10 <br />Page 1 of 1 <br />Mario Battigelli <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. Mario Battigelli <br />1307 Wildwood Drive <br />Chapel Hill NC 27514 <br />919- 942 -5756 <br />mcbattigelli @gmail.com <br />Retired <br />1965 <br />Chapel Hill <br />Male <br />Caucasian <br />12/18/1927 <br />Boards /Commissions applied for: <br />Adult Care Home Community Advisory Committee <br />Nursing Home Community Advisory Committee <br />Work Experience: <br />Practice medicine as faculty of medical school for 35 years. NHCAC 6 yrs <br />Volunteer Experience: <br />IFC volunteer, Chapel Hill(1 year). <br />Education: <br />MD, University of Florence Italy(1951), MPH, University Of Pittsburgh, PA. <br />Other Comments: <br />STAFF COMMENTS: Applied 2 -15 -01 for the Nursing Home Community Advisory <br />Committee. Reapplied for Adult Care Home Community Advisory Committee <br />10/19/2009. Reapplied for Nursing Home Community Advisory Committee 11/18/09. <br />ADDRESS VERIFICATION: 1307 Wildwood Drive, Chapel Hill is Chapel Hill township, <br />CH jurisdiction. <br />This application was current on: 11/18/2009 Date Printed: 11/23/2009 <br />