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'95 85/25 18:34 2 919 942 8154 U-WAY 0 81 <br /> I I<1ti' �ti-1395 <br /> 10:22 F idjrl U 444UL 1.1 Y "Mgn 1!_�b 1 u#_rcn <br /> s <br /> V .L NTEER APPL CATION <br /> ORANGE COUNTY BOARDS D COMMISSIONS <br /> If you are an Orange County resident, at leas 19 gears old, and Willing to <br /> volunteer your time and expertise to your c unity, please complete and <br /> return to: <br /> CowatT.'Cnuaissioners, Of# e <br /> P. 0. Box 8181 <br /> Hi. lsboroullg__ht NC 27278 <br /> NAME: Ani4a_ 'A' J.XA)�l►�.�� <br /> ROME ADDRESS: 3 e 14 <br /> zip ' e7$ <br /> TELEPHONE: M - 72*73 (g) 644— Z1 <br /> PLACE OF EMPLOYMM: All dAmkv . CDIJ <br /> It j <br /> JOB TITLE: <br /> ON X� LIST JOB, VOLUNTEER, AND EDUCAT ONAL EXPERIENCE AND/OR SKILLS <br /> YOU FOR US TO CONSIDER. <br /> IN ORDER TO ASSURE COUNTYWIDE REPRESENTATION pL SE INDICATE YOUR TOWNSHIP OF <br /> RESIDENCE: <br /> Bingham Cheeks <br /> Hillsborough Eno <br /> Chapex Rill Litt2e R�v <br /> Cedar Grove , <br /> WE ASE YOUR HELP IN ASSURING DIVERSITY OF MEK3 SHIP BY AGR, GENDER AND RACE, <br /> BY ANSWERING THE. FOLLO ING QU NSTIONS s <br /> Hale MKIC BACKGROUND: <br /> Female Atricsa American Hispanic <br /> -Caucasf an Other <br /> Native American <br /> DATE OF BIRTH: <br /> 2 a <br /> PLEASE LIST (IN ORDER Of PREFERENCE) THE BO DS/COMMXSSIONS ON WHICH YOU <br /> YOULA E WIhLXNQ ,T0 S <br /> i. <br /> 2. <br /> 3. <br /> 4. <br /> I <br /> i <br />