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6 <br />Page 1 of 2 <br />Max Mason <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 Ti#le: <br />Year of OC Residence: <br />Township of Residence: <br />Zone of Residence: <br />Sex: <br />Ethnic Background: <br />Date of Birth: <br />Mr. Max Mason <br />821 Tinkerbell Rd. <br />Chapel Hill NC 27517 <br />9196497937 <br />maxomason@yahoo.com <br />Principle Long Term Care, Inc. <br />Development Coordinator <br />1978 <br />Chapel Hill <br />Does not apply <br />Male <br />Caucasian <br />7/27/1977 <br />Boards/Commissions applied for: <br />Nursing Home Community Advisory Committee <br />Work Experience: <br />Development Coordinator for one of NC's largest long term care providers. Plan for <br />development of nursing facilities, hospices, and home health agency. Administrator for <br />residential recovery facility for pregnant women who struggled with substance abuse. <br />Volunteer Experience: <br />Serve on the Community Grantmaking Committee at the Triangle Community Foundation. <br />Board Member, Chrysalis Foundation for Mental Health <br />Member of APPLES Service Learning program at UNC-Chapel Hill as undergraduate. <br />Education: <br />BA, History, UNC-Chapel Hill <br />MA, Slavic Languages & Literatures, UNC-Chapel Hill <br />Current student (part-time): Masters of Healthcare Administration, UNC-Chapel Hill <br />Gillings School of Public Health <br />Other Comments: <br />As noted, I am presently a student in public health and currently work in the field of long <br />term care; thus, I have a great interest in the issues affecting nursing facility residents. <br />Given my experience and familiarity with this segment of the health care system, I <br />believe I would be a valuable addition to this committee. STAFF COMMENTS: <br />Originally applied (1/24/2011) for Nursing Home Community Advisory Committee. <br />ADDRESS VERIFICATION: 821 Tinkerbell Road is in Chapel Hill Township. <br />