Orange County NC Website
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VOLUNTEER APPLICATION <br /> ORANGE COUNTY BOARDS AND COMMISSIONS <br /> If you are an Orange County resident, at least 18 years old, and willing to <br /> volunteer your time and expertise to your community, please complete and <br /> return to: <br /> County Commissioners' Office <br /> P. 0. Box 8181 <br /> �lt <br /> Hillsborough, NC 27278 <br /> NAME: t� �nneS <br /> HOME ADDRESS: L4 .6 Wes! ey-%,,,av„4 Pn.4 <br /> , -) --� AAD�SS; <br /> IU() Zip Code , (n C-)9 <br /> TELEPHONE: (W) 1044-(oaLf`7 (H) <br /> PLACE OF EMPLOYMENT: t� n S Sc:app(� /o c . <br /> JOB TITLE: coa o.- <br /> ON REVERSE SIDE LIST JOB, VOLUNTEER, AND EDUCATIONAL EXPERIENCE AND/OR SKILLS <br /> YOU WOULD LIKE FOR US TO CONSIDER. <br /> IN ORDER TO ASSURE COUNTYWIDE REPRESENTATION PLEASE INDICATE YOUR TOWNSHIP OF <br /> RESIDENCE: <br /> Bingham Cheeks <br /> Hillsborough Eno <br /> Chapel Hill _ Little River <br /> Cedar Grove <br /> WE ASK YOUR HELP IN ASSURING DIVERSITY OF MEMBERSHIP BY AGE, GENDER AND RACE, <br /> BY ANSWERING THE FOLLOWING QUESTIONS: <br /> Male ETHNIC BACKGROUND: <br /> Female X African American Hispanic <br /> Caucasian _ Other <br /> Native American <br /> DATE OF BIRTH: <br /> I I jam <br /> PLEASE LIST (IN ORDER OF PREFERENCE) THE BOARDS/COMMISSIONS ON WHICH YOU <br /> WOULD BE WILLING TO SERVE. <br /> 1 . Vja `_�k Seruices Needs <br /> 2 . <br /> 3 . <br /> 4 . <br />