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l3 <br />Page 1 of 1 <br />Keith Bagby Sr. <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 />Township of Residence <br />Zone of Residence: <br />Sex: <br />Ethnic Background <br />Date of Birth: <br />Mr. Keith Bagby Sr. <br />902 Savannah Court <br />Hillsborough NC 27278 <br />(919)765-4292 <br />(919)245-3814 <br />Blue Crass Blue Shield of NC <br />Senior Underwriting Consultant <br />Hillsborough <br />Hillsborough Town Limits <br />Male <br />African American <br />11 /16/1955 <br />Boards/Commissions applied for: <br />Recreation and Parks Advisory Council <br />Hillsborough Planning Board <br />Work Experience: <br />I have worked in the insurance industry as an underwriter for 27 years. The companies <br />include Aetna, The Travelers', Blue Cross Blue Shield of MD, VA and NC. <br />Volunteer Experience: <br />Coach a boys 14 and under AAU/YBOA basketball team. <br />the past 5 years. <br />Coached a pee wee youth football team in Carrboro for 2 <br />Coached several youth football teams and worked as AD <br />Richmond, Va. <br />Education: <br />BS degree Virginia State University <br />I've helped coach this team for <br />years. <br />at a recreation site outside of <br />Other Comments: <br />I referee football and basketball for middle school, high school and recreation and parks <br />departments. STAFF COMMENTS: Originally applied for Recreation and Parks and <br />Hillsborough Planning Board. ADDRESS VERIFICATION: 902 Savannah Gourt is in <br />Hillsborough Town limits in Hillsborough's planning jurisdiction. <br />This application was current on: 6/23/2005 2:17:41 PM Date Printed: 3/10!2006 <br />