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9 <br /> Page 1 of 2 Sam Lasris <br /> Volunteer Application <br /> Orange County Advisory Boards and Commissions <br /> Name: Dr. Sam Lasris <br /> Name Called: <br /> Home Address: 7020 Caviness Jordan Rd. <br /> Cedar Grove NC 27231 <br /> Phone (Day): 919-732-7362 <br /> Phone (Evening): 919-732-7362 <br /> Phone (Cell): <br /> Email: samlasris @hotmail.com <br /> Place of Employment: Self Employed <br /> Job Title: Dentist <br /> Year of OC Residence: 1977 <br /> Township of Residence: Cedar Grove <br /> Zone of Residence: Cedar Grove Twnsp <br /> Sex: Male <br /> Ethnic Background: Caucasian <br /> Community Activities/Organizational Memberships: <br /> Volunteer for the Intenational Affairs Council of North Carolina, RDU Airport and the <br /> OUTBoard. <br /> Past Service on Orange County Advisory Boards: <br /> OUTBoard and Planning Board, past member <br /> Boards/Commissions applied for: <br /> Board of Health <br /> Background, education and experience relevant to this board: <br /> I have been a dentist since 1975, beginning in public health. I have accepted medicaid patients <br /> from Va throughout my career and NC medicaid patients as well. I would bring to the board first <br /> hand knowledge of the needs of the diverse population of Orange county and could serve as a <br /> liaison between the OUTBoard and the Board of Health. <br /> Reasons for wanting to serve on this board: <br /> Conflict of Interest: <br /> Supplemental Questions: <br /> Other Comments: <br /> STAFF COMMENTS: APPLIED FOR BOARD OF HEALTH 10/4/2013. Applicant since <br /> 2000. Renewed application 10/02/01 for Recreation Parks, Economic Development, and <br /> Arts Commission. Renewed application for Planning Board on 03/08/02. Reapplied <br /> 10/19/2005 for OUT Board. Renewed application 10/26/2012 for OUT Board. ADDRESS <br /> VERIFICATION: 7020 Caviness Jordan Rd., Cedar Grove, NC is Cedar Grove Township, <br />