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Volunteer Application <br />Orange County Advisory Boards and Commissions <br />Tiketha Collins Page 1 of 2 <br />Home Address:600 S. Churton Street <br />Township of Residence: Hillsborough <br />Zone of Residence: <br />Ethnic Background:African American <br />Sex:Female <br />Phone (Day):9193329917 <br />Phone (Evening):9193329917 <br />Phone (Cell):9193329917 <br />Email:tikethacollins@gmail.com <br />Name: Tiketha Collins <br />Boards/Commissions applied for: <br />Hillsborough NC 27278 <br />Place of Employment: Durham Nursing and Rehab <br />Job Title:Director of Social Services <br />Name Called: <br />Year of OC Residence:2015 <br />Community Activities/Organizational Memberships: <br />None at this time. I have a great interest in the aging <br />Past Service on Orange County Advisory Boards: <br />none <br />Advisory Board on Aging <br />Background, education and experience relevant to this board: <br />I have worked with the aging for over 10 years. I have studied gerontology on graduate level. <br />Reasons for wanting to serve on this board: <br />I desire to assist in the programs that directly affect the aging in my community. <br />Conflict of Interest: <br />Adult Care Home Community Advisory Committee <br />Background, education and experience relevant to this board: <br />I have worked with the aging for over 10 years. I have studied gerontology on graduate level. <br />Reasons for wanting to serve on this board: <br />I desire to assist in the programs that directly affect the aging in my community and ensure the <br />well being of those in placement. . <br />Conflict of Interest: <br />15