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54 <br />Page 1 of 2 <br />Edward Stirman <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. Edward Stirman <br />554 E Hatterleigh Ave <br />Hillsborough NC 27278 <br />919- 241 -4912 <br />919- 241 -4912 <br />423 - 677 -3295 <br />monty.stirman @gmail.com <br />retired <br />retired <br />2012 <br />Hillsborough <br />Male <br />Caucasian <br />Community Activities /Organizational Memberships: <br />none <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 />family practice physician in practice in TN for 34 years <br />Reasons for wanting to serve on this board: <br />would like to volunteer in area more likely to have some expertise <br />Conflict of Interest: <br />Hillsborough Planning Board <br />Background, education and experience relevant to this board: <br />physician from TN- retired <br />Reasons for wanting to serve on this board: <br />interested in helping Hillsborough improve <br />Conflict of Interest: <br />Supplemental Questions: <br />Other Comments: <br />