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RE S UME <br /> Name of Nominee: Roma J. Harris <br /> Mailing Address: 21 Willvv Terrace Apt. <br /> Chapel Hill, kt, C. Zip Code 27514 <br /> Telephone: Home 967-5565 Business <br /> Ethnic Background: Black Indian White <br /> Other <br /> Sex: Male- Female X <br /> Age: 67 <br /> Educa-'C-ion: (Highest) YUgh School <br /> Occupation: Retired <br /> Community Interests and Activities Friends of 1-Jursin-a Home Patients <br /> Olin T. Hinkley Baotist Church <br /> Volunteer Pine Ridge Hursinq Home <br /> Volunteer 1.1, C. lilemorial Fospi tal <br /> Volunteer Council O Arxin <br /> Nursing Home Advisory Comm. <br /> NominateP� to ReDresent what area of CoUntyLL--1- <br /> (Not applicable in some instances) <br /> Cha,oel Hill <br /> Boards on which I am interested in serving are: <br /> Friends of Nursing Home Patients <br /> 7. <br /> Date: .......1.2-1 Signature of Nominee <br />