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9 <br />Page 1 of 1 <br />Jerry Schreiber <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. Jerry Schreiber <br />1606 Pathway Dr <br />Carrboro NC 27510 <br />919 967 2962 <br />919 967 2962 <br />919 259 2359 <br />jrogerschreiber @gmail.com <br />retired <br />n/a <br />2006 <br />Chapel Hill <br />Male <br />Caucasian <br />Community Activities /Organizational Memberships: <br />SCORE <br />Past Service on Orange County Advisory Boards: <br />None <br />Boards /Commissions applied for: <br />Nursing Home Community Advisory Committee <br />Background, education and experience relevant to this board: <br />My mother -in -law is a current resident in a nursing home and has been a resident in several <br />others. <br />Reasons for wanting to serve on this board: <br />Having seen the shortcomings of care at a number of facilities both here and in Dallas, I believe <br />I can lend a first hand view of what can and should be viewed. <br />Conflict of Interest: <br />Supplemental Questions: <br />Other Comments: <br />This application was current on: 5/19/2014 1:47:17 PM Date Printed: 5/27/2014 <br />