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RESUME' <br /> Name: . ia. 421 en ._ <br /> hailing Addres�: <br /> Code /�L <br /> `f"el ephone: Flome <br /> Business <br /> Ethnic Background: Black Indian White w Other <br /> Sex: Male _ Female _/ Age; I <br /> Education: (Highest) �, f . f <br /> Occupation: <br /> U <br /> Community Inter sts and Actiyities: rf <br /> ,�Pj <br /> /' f <br /> �..{... ,{..l.C...C.' �lTi4.�?.- '/'t _ �i(1�LC.G<t.:.L.i•'v't/E� <br /> What segment of county or population would you represent <br /> (Not applicable in some instances) <br /> I am interested in serving on: <br /> Date: Signature <br /> e <br /> 4 <br />