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27 <br />~` BUiNCt)MBE <br />~,M,`"`r~ ~~ t„1 NTY <br />NORFtt CARQLIkVA <br />M1~~~I~r1~ -coutxn~aeus-.~- <br />Yt~tn 1'atrrrr itfreu ('nmmu+dtp <br />Buncombe County Board of Commissioners <br />David Gantt, Chairman <br />K. Ray Bailey, Commissioner <br />Carol Peterson, Commissioner <br />Bill Stanley, Commissioner <br />Holly Jones Commissioner <br />Application for Appointment to: <br />(Board or Commission name) <br />Name: Date: <br />Home Address <br />Business Name: <br />Address ~ Phone: <br />E-mail: <br />List any County Board, Committee or Commission on which you currently serve: <br />How did you hear about this Board vacancy? <br />For the purpose of diversity and balance, please complete the following: <br />Race Male Female <br />Buncombe County residency is required for appointment to any board or commission. <br />I am a resident from the North_ South_ East_ West City of Asheville <br />(check one) <br />I have been a resident of Buncombe County for years. <br />Return application to: <br />Clerk to the Board of Commissioners <br />205 College Street Suite 300 <br />Asheville, NC 28801 <br />kathy. hughes@buncombecounty. org <br />Phone: 828-250-4105 <br />FAX: 828-250-6077 <br />Signature of Applicant (this application will be kept on file for one year) <br />Buncombe County does not discriminate on the basis of race, color, religion, sex, age, national origin, handicap or disability in <br />admission or access to or treatment or employment in its services, programs and activities in compliance with applicable federal and state laws. <br />Information given on this application is public record. <br />buncambecaunty.org <br />