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23 <br />Page 1 of 1 <br />Steven Thomas Daniels <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 />Dr. Steven Thomas Daniels <br />206 Franklin Adams Road <br />Efland NC 27243 <br />919- 732 -8213 <br />919- 451 -1874 <br />919- 451 -1874 <br />stdaniel @gmail.com <br />Self <br />Dentist <br />2009 <br />Cheeks <br />County <br />Male <br />Caucasian <br />Community Activities /Organizational Memberships: <br />NC MoM <br />NC Dental Society <br />Hillsborough Chamber of Commerce <br />Hillsborough Exchange Club <br />Past Service on Orange County Advisory Boards: <br />None <br />Boards /Commissions applied for: <br />Board of Health <br />Background, education and experience relevant to this board: <br />Dentist since 2010. MoM Clinics & experience with the SHAC Clinic @ UNC. <br />Reasons for wanting to serve on this board: <br />Oral health outreach <br />Conflict of Interest: <br />Supplemental Questions: <br />Other Comments: <br />This application was current on: 1/15/2014 1:37:49 PM Date Printed: 7/17/2014 <br />