|
�j k a
<br /> , �`
<br /> T,I ;. . . .4-...
<br /> f .i. E..t ;�a! y,(•I
<br /> i
<br /> .. ,, ...._ . ._-... , .
<br /> flame= •\ ,t� „ „, .,.-> - ,. __ . .
<br /> flailing Address: ,' Grc ' ,;,: ;ll } 4- —1 .=•.,_-- -
<br /> Zip Code a-7 2
<br /> €.
<br /> Telephone: z' - Home ` (a-cif 2•t 6-/L us7ness
<br /> -
<br /> Ethnic Background: Black Indian Mite Other
<br /> - Sex. hale ' ,' Female , :_Age: ,K-$.! ;_tr »,
<br /> • Education: (highest) ?, S • . . -
<br /> Occupation: . ` e .rr` !.
<br /> C v»�C �c 4 r !"�Y+o el K,`': r.4.a `k"c i
<br /> - Community InFerests arid Activities. cc�,.,, 1;4.., \.4- . S,
<br /> \i1/44..e, 'sv;.,....1 (74". .adi......„ 1. "CP 1, Z.* ... ■,....,-7.t..-1 .0 .- ik
<br /> n 'tY:1`i`\ ..f S.:"_3l.41r_ rL,�.",,,av .. S L •..^ vs M .. . •«�^.
<br /> LN.s i C'cv C oy *,. •', c' ` 1., . '.�.c _. • .
<br /> In Which tolFnshi do 'ou reside? . , .,
<br /> . . (not applicable in some instances) '° .
<br /> •
<br /> X am interested in serving on „ . ' A.
<br /> _ :�
<br /> Date: . 6. l Ti7 Signature ; , • a'w!;..4_ '-.c _.,•
<br /> Rgtgrn kg; ! Clerk; to the Board of County Commissioners
<br /> 1 106.1. fargarEt bone
<br /> flit isborou}h, NC 27.278•
<br /> r
<br /> ,., _,rye'T .J^:-J, -- ,
<br />
|