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19 <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 />Phone (Cell): <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 />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 />Boards /Commissions applied for: <br />Nursing Home Community Advisory Committee <br />Community Activities /Organizational Memberships: <br />Past Service on Orange County Advisory Boards: <br />Work Experience: Development Coordinator for one of NC's largest long term care <br />providers. Plan for development of nursing facilities, hospices, and home health agency. <br />Administrator for residential recovery facility for pregnant women who struggled with <br />substance abuse. <br />Volunteer Experience: Serve on the Community Grantmaking Committee at the Triangle <br />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: 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, <br />believe I would be a valuable addition to this committee. STAFF COMMENTS: <br />