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12 <br />Page 1 of 1 <br />Stephen Bank <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 Stephen Bank <br />7404 Dodsons Xrd <br />Hillsborough NC 27278 <br />9199296369 <br />9199296369 <br />not used <br />stevebank @gmail.com <br />retired <br />na <br />2004 <br />Bingham <br />Male <br />Caucasian <br />Community Activities /Organizational Memberships: <br />None. Graduated in 1966 with MA in psychology and completed all classes for PhD in <br />psychology (did not complete dissertation). Have worked in mental health capacities from <br />1966 until retirement from Lutheran Family Services ACT Team in 2010. <br />Past Service on Orange County Advisory Boards: <br />none <br />Boards /Commissions applied for: <br />Adult Care Home Community Advisory Committee <br />Background, education and experience relevant to this board: <br />As previously stated - Psychology graduate degree and work experience in field since 1966. <br />Reasons for wanting to serve on this board: <br />I know a little something about the field and might have significant insight. <br />Conflict of Interest: <br />Supplemental Questions: <br />Other Comments: <br />This application was current on: 7/28/2014 3:39:35 PM Date Printed: 7/29/2014 <br />