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<br />Town ETJ a/ Trans.Area <br />1~®WN OF CARRBCJRO .~""a, <br />~':c'k':(-t~:A;~' ~ ~Ft~"~tr;^:~mxS'c~~s~ ,~.ar;~~.~us.,sN 3,s~t~'~-' e,1~':a-'.u~s~ ~ ~4~x~scr~~:i~t3~u~x~'~ ~`~ ~, x'ti~~ y .s .- <br />NAME: r r~Dlt~ C7,~iy~'°~ DATE: /~/~lL ~ ~p~ <br />_e../ <br />ADDRESS:' 6~.~~~ ~ Zn87 = 1U8~- ~ WAS ICd . Z7~1~ ~f~e.c~ly ~ 7~°~ ~ <br />r- ~ <br />IS THIS ADDRESS LOCATED WITHIN THE CORPORATE LIMITS OF THE TOWN OF CARRBORO? <br />TELEPHONE: [HOME] Rig 415 [BUSINESS] 336 5~ /(Z9E-MAIL ADDRESS: 1r9~~'~~i ~~, Cd dtq, <br />DATE OF BIRTH ~i~lb Zy , ! ~~ l RACE: ~ SEX:J~ OCCUPATION~jjdJ~`" st{~9jUr'-~ <br />ARE YOU A REGISTERED ORANGE COUNTY VOTER? LENGTH OF RESIDENCE IN ORANGE COUNTY. ~~ TOWN OF CARRBORO <br />COMMUNITY ACTIVITIESIORGANIZATIONAL MEMBERSHIPS: <br />1 wish to be considered for appointment to the following advisory board(s): <br />;/ Board of Adjustment Northern Transition Area Advisory Com. <br />Appearance Commission/NPDC OWASA Board of Directors • <br />Arts Committee Orange County Economic Dev. Com. <br />Cable T.V. Committee •• - Orange County Human Relations Com. • <br />Cemetery Commission Personnel Advisory Committee <br />Economic Sustainability Commission Planning Board <br />Environmental Advisory Board Recreation & Parks Commission <br />Humaa Services Commission Transportation Advisory Board <br /> Other <br />Z7311~ <br />If you apply for membership on more than one advisory board, please indicafe your preference by <br />number, with "7" being your first choice (please limit your selection to fyvo (2J boards). Please note <br />that membership is limited to one advisory board at a time. You shall not be considered for <br />appointment to another board unless you resign before filing an application or you are in the last six <br />months of your current term. <br />EXPERIENCE TO AID YOU IN WORKING ON THESE ADVISORY BOARDS: <br />~/ ~N7~+Ze~P' iN jvg~rNnRG~' 1?€sld'.aJ <br />REASON(S~ YOU WISH TO BE APPOINTED: <br />~aLV~% at~aa~M~~' ~SSyFf or( p~¢mvem~ Yjl/t~pto,J <br />HAVE YOU EVER SERVED ON ANY TOWN OF CARRBORO ADVISORY BOARD? IF "YES", WHICH ONE(S~ ~~. <br /> <br />RETURN THIS FORM TO: TOWN CLERK, 301 WEST MAIN STREET, CARRBORO, N. G 27510 <br />www. towno fcarrboro. org <br />