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12 <br />Page 1 of 1 <br />Sam Lasris <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 />Dr. Sam Lasris <br />7020 Caviness Jordan Rd. <br />Cedar Grove NC 27231 <br />919- 732 -7362 <br />919- 732 -7362 <br />samlasris @hotmail.com <br />Self Employed <br />Dentist <br />1977 <br />Cedar Grove <br />Cedar Grove Twnsp <br />Male <br />Caucasian <br />Boards /Commissions applied for: <br />Community Activities /Organizational Memberships: <br />Past Service on Orange County Advisory Boards: <br />OUTBoard and Planning Board, past member <br />Other Comments: <br />STAFF COMMENTS: Applicant since 2000. Renewed application 10/02/01 for <br />Recreation Parks, Economic Development, and Arts Commission. Renewed application <br />for Planning Board on 03/08/02. Reapplied 10/19/2005 for OUT Board. Renewed <br />application 10/26/2012 for OUT Board. ADDRESS VERIFICATION: 7020 Caviness <br />Jordan Rd., Cedar Grove, NC is Cedar Grove Township, Orange County Jurisdiction, <br />and Agricultural Residence Zoning. <br />This application was current on: 10/26/2012 Date Printed: 3/8/2013 <br />