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12 <br />Page 1 of 2 <br />Keith Bagby Sr. <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 Title: <br />Year of OC Residence: <br />Township of Residence: <br />Zone of Residence: <br />Sex: <br />Ethnic Background: <br />Date of Birth: <br />Mr. Keith Bagby Sr. <br />902 Savannah Court <br />Hillsborough NC 27278 <br />919-765-4292 <br />(919) 245-3814 <br />keith.bagby@bcbsnc.com <br />Blue Cross Blue Shield of NC <br />Senior Underwriting Consultant <br />2000 <br />Hillsborough <br />Hillsborough Town Limits <br />Male <br />African American <br />11 /16/1955 <br />Boards/Commissions applied for: <br />Alcoholic Beverage Control Board <br />Work Experience: <br />I have worked in the insurance industry for 32 years, including 26 years with various Blue <br />Cross Blue Shield Plans. Also referee football and basketball in the Triad and Triangle <br />for recreation leagues, Middle and High School. <br />Volunteer Experience: <br />Coach a boys 14 and under AAU/YBOA basketball team. I've helped coach this team for <br />the past 5 years. <br />Coached a pee wee youth football team in Carrboro for 2 years. <br />Coached several youth football teams and worked as AD at a recreation site outside of <br />Richmond, Va. Current on the Orange County Parks and Recreation Council and <br />Intergovernmental Parks Work Group. Also currently a Big Brother or the Big Brothers <br />and Big Sisters of the Triangle Organization <br />Education: <br />Received a BS Degree from Virginia State University in 1978 Petersburg, Va. <br />Other Comments: <br />I referee football and basketball for middle school, high school and recreation and parks <br />departments. STAFF COMMENTS: Originally applied for Recreation and Parks and <br />Hillsborough Planning Board. UPDATE: Applied for Alcoholic Beveerage Control Board <br />1/20/2011. ADDRESS VERIFICATION: 902 Savannah Court is in Hillsborough Town <br />limits in Hillsborough's planning jurisdiction. UPDATED APPLICATION 03/21/2011. <br />