Orange County NC Website
AGENDA ATTACHMENT 11 <br /> cI 7 <br /> . of Nam-snei, - <br /> 141�-,.ilinc AdftresS : <br /> zip Code 7 <br /> Tele?hone : dome L • Y SG Business <br /> Ethnic Bacl:ground: Black Indian jqhite other <br /> Sex: Male— re-male <br /> Age; <br /> Educatt-43-0,n: (HighestLI-1) <br /> occupation: <br /> Co-t,Ltj, uaity interests and Activities <br /> to R,,,present 'chat. area of Cou.-It-v —--,-- <br /> (Not applicab e in some instances) <br /> Boards an whit I am interested in serving are; <br /> Pate SignaE-urc of Nominee <br />