Agenda - 01-20-2000 - 11 - Laserfiche WebLink

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VOLUNTEER APPLICATION ORANGE COUNTY BOARDS AND COMMISSIONS If you are an Orange County resident, at least 18 years old, and willing to volunteer your time and expertise to your community, please complete this application and return to: Orange County Commissioners Office P.O. Box 8181 �� 1 Hillsborough, NC 27278 �� . Jm 1 8 M if Phone (919);732 - 8181-, 688- 7331;968 -4501; 227 -2031 Ext. 2125, 2129 or 2130 - Fax: (919 644 -0246) NAME : -------------------------- - - - - -- Derek Brown HOME ADDRESS: ----------- - - - - -- 600 S. Churton St. Apt 8 CITY: --------------------------- - - - - -- Hillsborough STATE. -------------------------- -- - - -- NC ZIP CODE: -------------------- - - - - -- 27278 TELEPHONE: (Home) -------- - - - - -- 643 -0654 TELEPHONE: (Work) --------- - - - - -- 836.5572 TELEPHONE: (FAX) --------- - - - - -- n/a EMAIL: -------------------- - - - - -- -- DBUnited77 @aol.com PLACE OF EMPLOYMENT: --- - -- Raleigh - Paging Network of NC(PAGENET) JOB TITLE: ------------------ — - — — - Network Services - Systems Technician TOWNSHIP OF RESIDENCE: - - -- Hillsborough ZONE OF RESIDENCE: ----- - - ---- Does not apply SEX: - - - - -- - ------ - - - - -- --- --- - -- Male ETHNIC BACKGROUND: --- - - - - -- Caucasian DATE OF BIRTH: --- -- - - - -- 08/1!197 LIST, IN PREFERENCE, THE BOARDS /COMMISSIONS ON WHICH YOU WOULD BE WILLING TO SERVE: •C/b - 1: --------------- - - - - - -- Soccer Syposium Task Force 2. ------------------ — -- 3 - --------- - - --- ----- - Please list any work, volunteer and/or educational experience you would like to have considered in the review of your application. WORK EXPERIENCE: Prior US Air Force Soccer Camps as a player; Coach clinic in St. Louis for youth league as assistant coach VOLUNTEER EXPERIENCE: Assistant Coach for Varsity /Junior Varsity Orange High School 98 -99; Assistant Coach for youth in Belleville Area(Illinois) 96 -97; Volunteer for the US Olympic Committee in St Louis 94.