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Page 1 of 2 <br />Keith Bagby <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 Keith Bagby <br />902 Savannah Court <br />Hillsborough NC 27278 <br />(919)245 -3814 <br />(919)618 -4797 <br />(919)618 -4797 <br />keith.bagby @bcbsnc.com <br />Blue Cross Blue Shield of North Carolina <br />Senior Underwriting Consultant <br />2000 <br />Hillsborough <br />Male <br />African American <br />Community Activities /Organizational Memberships: <br />I was a member of the Orange County Parks and Recreation Council for 7 years from <br />2006 - 2013. When my time expired I was co- chair. <br />Past Service on Orange County Advisory Boards: <br />I served on the Orange County Parks and Recreation Council from 2006 - 2013. When <br />my time expired I was a Co- Chair. <br />Boards /Commissions applied for: <br />Alcoholic Beverage Control Board <br />Background, education and experience relevant to this board: <br />have a BS degree from Virginia State University. I am a business professional working as a <br />Senior Underwriting Consultant for Blue Cross Blue Shield of North Carolina. I have worked in <br />the Insurance industry for over 30 years. My experience previously serving on the Orange <br />County Parks and Recreation Council and currently on the Intergovernmental Parks Work Group <br />is an asset towards participating on this board. <br />Reasons for wanting to serve on this board: <br />I would like to be a part of a group that Mr. Keith Cook is participation becasue I admire him and <br />look to him as a leader inour community. Also serving on the Orance County Parks and <br />Recreation Commission has given me a taste of what it means to serve the people of Orange <br />County North Carolina. <br />Conflict of Interest: <br />Supplemental Questions: <br />