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12 <br />Name: <br />Address: <br />Town: <br />Phone: (work) <br />APPLICATION FORM <br />Township: <br />(home) <br />Occupation <br />I volunteer to serve for a minimum of twelve (12) months as a <br />member of the Orange County Solid (caste Committee: <br />Signature: Date: <br />Please answer the questions below. <br />1) Why do you want to serve on the Orange County Solid Waste <br />Committee? <br />2) Is there any interest or experience that you have which <br />would be particularly helpful to the committee? <br />3) Briefly describe your background. <br />4. <br />Application must be submitted by February 14, 1992. Return <br />to: <br />Orange County Public Works Department, P.O. Box 8181, <br />Hillsborough, N.C. 27278 <br />