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~P <br />Page 1 of 1 <br />Peggy Cohn <br />Volunteer Application <br />Orange County Advisory Boards and Commissions <br />Name: <br />Name Called: <br />Home Address: <br />Phone: (Day) <br />Phone: (Evening) <br />Fax: <br />Email: <br />Place of Employment: <br />Job Title: <br />Ms. Peggy Cohn <br />Peggy <br />10 Bayswater Place <br />Chapel Hill NC 27517 <br />919-489-6624 <br />same <br />peggycohn 1 @earthlink. net <br />retired <br />Geriatric Care Manager <br />Township of Residence: Chapel Hill <br />Zone of Residence: C.H, City Limits <br />Sex: Female <br />Ethnic Background: Caucasian <br />Date of Birth: 8/28/1938 <br />Boards/Commissions applied for: <br />Adult Care Home Community Advisory Committee <br />Nursing Home Community Advisory Committee <br />Advisory Board on Aging <br />Work Experience: <br />Community Health Nursing educator UNC and Penn State University <br />Director of Family Ties, Geriatric Care Management, State College PA <br />Volunteer Experience: <br />Nursing Home visitation <br />Non profit Boards in PA <br />Education: <br />BA, Wellesley <br />BSN, Coltambia University <br />MPH, UNC <br />PhD, Penn State University College of Health and Human Developmenet <br />Other Comments: <br />STAFF COMMENTS: Originally applied for Adult Care Home Community Advisory <br />Committee and NHCAC and Adv. Board on Aging 10/10/2005, ADDRESS <br />VERIFICATION: Mailing address listed above, Residence is 233 McCauley Street in <br />Chapel Hill city limits,. <br />This application was current on: 10/10/2005 11:34:21 AM Date Printed: 2/7/2006 <br />