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16 <br /> VOLUNTEER APPLICATION <br /> ORANGE COUNTY BICYCLE TASK FORCE <br /> This application is a public document <br /> If you are at least 18 years old, and willing to volunteer your time and expertise to the Orange County <br /> Bicycle Safety Task Force, you may complete this application and mall/email It by March 8:1„2Q.16 to the <br /> address/email below: <br /> Orange United Transportation Board <br /> (OUTBoard) <br /> c/o Abigalle Pittman, Planning Department <br /> P.O.Box 8181 <br /> Hillsborough,NC 27278 <br /> Phone(919)246-2667 <br /> Email:abpJap @©rapgecounnc.gvv <br /> Your application will be considered by the Commissioners when reviewing and making appointments, <br /> Eli Belz <br /> NAME: <br /> 209 Norwich Ct. <br /> HOME ADDRESS: <br /> Efland 27243 <br /> CITY: Zip Code:, <br /> 919-360-7950 919-360-7950 919-360-7950 <br /> PHONE: (Day) (Evening/late) (Cell) <br /> embbelz64 @gmall.com <br /> EMAIL: <br /> Hillsborough Bicycle Manager <br /> PLACE OF EMPLOYMENT: JOB TITLE: <br /> ARE YOU AT LEAST 18 YEARS OF AGE? <br /> Yes ® No 0 <br /> ARE YOU A MEMBER OF ANY OF THE FOLLOWING GROUPS? (Check all that apply) <br /> R Law enforcement agency 151 Orange County business Hillsborough/Orange <br /> School representative ® Bicycle advocacy group Chamber of Commerce <br /> Orange County Visitors Bureau <br /> El <br /> Orange County Planning Chapel Hill/Carrhoro <br /> NCDOT _ Department staff Chamber of Commerce <br /> Group working with drivers education _ Regional planning staff <br /> classes and/or traffic offenders <br /> PLEASE LIST YOUR CURRENT COMMUNITY ACTIVITIES/ORGANIZATIONAL MEMBERSHIPS: <br /> Durham Bicycle Co-operative <br />