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GOVERNOR'S 1982 STATEWIDE VOLUNTEER AWARDS <br /> INDIVIDUAL VOLUNTEER OFFICIAL SELECTION FORM <br /> CATEGORY OF AWARDS <br /> Circle Only One-• r <br /> 1. Individual Human Service Volunteer <br /> 0 Individual. Community Volunteer Leader <br /> 3. Administrator/Coordinator of Volunteers <br /> 4. Youth Volunteer <br /> 5. Senior Citizen Volunteer <br /> 6. Disabled Person Volunteer <br /> 7. School Volunteer <br /> 8. One-to-One Volunteer <br /> Please Type or Print <br /> DOT PETTY <br /> (Name of Nominee selected as it should appear on award) <br /> Hwy 70 Hillsborou:h NC 27278 <br /> (Address, County, City, Zip Code) <br /> (919) 732-3421 <br /> (Daytime Telephone Number) `� <br /> Description of Service <br /> Briefly describe the contribution this nominee has made, how it has affected <br /> { the community and why this nominee should represent your county in this <br /> category. (If additional space is needed, please attach sheet) <br /> This distinguished nominee has served the Cameron Park School as Parent <br /> Dental Volunteer for the past three years. She serves also as a grade mother, <br /> assists with field trips and fund raising activities sponsored by the school. <br />