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

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VOLUNTEER APPLICATION ORANGE COUNTY BOARDS AND COMNUSSIONS 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 ! Hillsborough, NC 27278 4 Phone (919) 732 -8181; 688 -7331; 968 -4501; 227 -203 Ext. 2125, 2129 or 2130 Fax: (919 6440246) NAME: ---- - ----- ---- -- - - -- ---- -- --- Anthony Larson HOME ADDRESS: --------- - - - - -- 405 Morrison Dorm CITY: --------------------------- - - - - -- Chapel Hill STATE: ----------------------- - - - - -- NC ZIP CODE: --- ----------- - --- - ------ 27514 TELEPHONE: (Home) -------- - - - - -- 919- 914 -4467 TELEPHONE: (Work) --------- - - - - -- 919423- 7844 TELEPHONE: (FAX) ---------- - - - - -- N/A EMAIL: --------------------------- - - - - -- larson @email.unc.edu PLACE OF EMPLOYMENT: - - - - -- Childcare work for two Chapel Hill / Carrboro Families JOB TITLE: ---------- --------------- Childcare Provider TOWNSHIP OF RESIDENCE: - - -- Chapel Hill ZONE OF RESIDENCE: ------ - - - - -- Does not apply SEX: --------------------------- - - - - -- Male ETHNIC BACKGROUND: --- - - - - -- Caucasian DATE OF BIRTH: =----------- - --- -- 12/28/79 LIST, IN PREFERENCE, THE BOARDS /COMMISSIONS ON WHICH YOU WOULD BE WILLING TO SERVE: 1: ------------- ----- --- Innovation and Efficiency Committee 2- ------ -- --- ---- ------ Arts Commission 3. -------------- - - - - -- Community College Taskforce Please list any work, volunteer and/or educational experience you would like to have considered in the review of your application. WORK EXPERIENCE: Legislative Intern for Rep. Veral Insko (Summer'99)3 years experience in childcare professions VOLUNTEER EXPERIENCE: Volunteer for the North Carolina Committee to Defend Health Care EDUCATIONAL EXPERIENCE: Full time student @ UNC- CHMajoring in Public Policy Analysis and Religious Studies