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1 <br />Town ET7 / Trans.Area <br />TowN of cARR~eoRO .~.... <br />. • ,~, P <br />NAME: r J ~/~ C <br />ADDRESS:' <br />IS THIS ADDRESS UOCATED WITHIN THE CORPORATE LIMITS OF THE OWN OF CARRBORO? <br />TELEPHONE: [HOME] R~'D 4~~1~I [BUSINESS] ~j lb 5~ /~1Z9E-MAILADDRESS: /,~J'I~N~Or q~~/f/YLYJ, Cd fib(, <br />~V ~'-` <br />DATE OF BIRTH ~jl?/b ZV~; !~(o5 RACE: ~ SEX:/t'J OCCUPATION p~~~"" /LG~Jj~~iC~( <br />ARE YOU A REGISTERED ORANGE COUNTY VOTER? LENGTH OF RESIDENCE IN ORANGE COUNTY. ~~ TOWN OF CARRBORO <br />COMMUNITY ACTIVITIES/ORGANIZATIONAL MEMBERSHIPS: <br />~~~~1~ ~,~~ C,~s~~~y <br />I wish to be considered for appointment to the following advisory board(s): <br />Board of Adjustment <br />Appearance Commission/NPDC <br />Arts Committee • <br />Cable T.V. Committee - - <br />Cemetery Commission <br />Economic Sustainability Commission <br />Environmental Advisory Board <br />Human Services Commissioa <br />DATE: /~f'/1/G ~ ~IU~' <br />OWASA Board of Directors <br />Orange County Economic Dev. Com. <br />Orange County Human Relations Com. <br />Personnel Advisory Committee <br />Planning Board <br />Recreation & Parks Commission <br />Transportation Advisory Board <br />Other <br />Z~~1lp <br />If you apply for membership on more than one advisory board, please indicate your preference by <br />number, with "9" being your first choice (please limit your selection to two (2) boards). P'/ease note <br />that membership is limited to one advisory board of 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 /> <br />A~ lN7N2~5P' ~N SvSfiT~~Bt~' DE'st~n/ <br />iON~S~ YOU WISH TO BE APPOINTED: <br />jaGV~' 'DEn'KOfY" /SSv~f Or( peoy~AE 9j/R~q~tanl ./ <br />HAVE YOU EVER SERVED ON ANY TOWN OF CARRBORO ADVISORY BOARD? IF "YES", WHICH ONE(S) l~0. <br />Northern Transition Area Advisory Com. <br />RETURN THIS FORM TO: TOWN CLERK, 301 WEST MAIN STREET, CARRBORO, N. C. 27510 <br />www.townofcarrboro.org <br />