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ORANGE COUNTY RESIDENTS APPLICATION - allll5?7 <br />COUNTY BOARDS AND COMMISSIONS <br />Name: /C• /ti/f X.,k- %I s --k C, Date: �!/!Z <br />Street:- 272,0 14117P'1451-D RP. <br />Town: DILL �t3u,�' PU1GI� -___ -_ Zip: _2- 7z 78 - -- - -- <br />Telephone: Day: - V77-- 2,/93 -- -- Evening:-73�i_- VC 2, z-- _ <br />Ethnic Background: Afro American_ Caucasian____`!_ -___ <br />Native American Other -------------- <br />Male v1 Female Date of Birth <br />Occupation:__ - -- L-------- - - - - -- <br />j Community Interests and Activities: C_OMIt N 1] Cfj�G�._LC ©J� Gfl �GL• IV <br />5C1C,[ j_ C'on/C4r,2n/S 4- COFP-CE 0t4.S� /�'AWUCTioit% Col -iM/? ��ES �h�iyf3rre- , C'f7�f1 //ie <br />l�Eivo�tlnl,4 �'i�n/ftt, AFF41 p5 _CcJ- _F_o_�'_ i� Gr _U_Ni7,g,Z �F_ 1 uN► VCS,' �}_��_S T__C_dAIC-4 119Ti� <br />o F Nf c.c.s g a/ZO u G -N E,Q v� o.�l i,�v r r✓,g T crJ.p r - s r - ",f IN & COI W'? / 77-Ct5- 0,07- <br />uU lve,i, -Wogt< o"'% lNpl c e 6vu .4F /frfi� Sc�A�',v� �tM�,Q,c,�.✓ XGye <br />----------------------- <br />f?"Bftc-- �'7KSfc %��_�__,�__ <br />Township of Residence: <br />Bingham Cedar Grove <br />----- Cheeks <br />_____Eno Chapel Hill _ `!� Hillsborough <br />Little River Do you reside in the extraterritorial area of a municipality? <br />yes noPoSs <br />Please list in order of preference Ae Board /Commission(s) on which you <br />would like to serve: <br />7/o,,/ 4 6f ets_G¢A ✓lSo�l -Cu d,,�c /�- 0,.,ja4P7 W198 <br />30i b V lSa,eZ_ L_ a,,/ i1 G-�nJf, ---- - - ---- <br />Remarks: T �FT_In/ <br />NIf W/¢C-EMCAI 7— <br />10 -9a/`� puke 4Al V /%d?�. //VTF w"f rleu.44- R 66,,t>"/0 -VS j <br />�2,YA5__Cyeff - _ c_ovr _s�<aa,cc _ i.✓ _ �u_7 REL ,_� scscic�uo Y __ <br />Signature: r - -- -- -- <br />Return to: Beverly Blythe <br />Clerk to the Board of County Commissioners <br />P. O. Box 8181 iQ97 <br />Hillsborough, NC 27278 E <br />(PlaWai;r 1'/97 <br />