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Page 1 of 2 <br />Volunteer Application <br />Tiketha Collins <br />Orange County Advisory Boards and Commissions <br /> <br />Name: Tiketha Collins <br />Name Called: <br />Home Address: 600 S. Churton Street <br />Hillsborough NC 27278 <br />Phone (Day): 9193329917 <br />Phone (Evening): 9193329917 <br />Phone (Cell): 9193329917 <br />Email: tikethacollins@gmail.com <br />Place of Employment: Durham Nursing and Rehab <br />Job Title: Director of Social Services <br />Year of OC Residence: 2015 <br /> <br />Township of Residence: Hillsborough <br />Zone of Residence: <br />Sex: Female <br />Ethnic Background: African American <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 /> Boards/Commissions applied for: <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 /> <br />Reasons for wanting to serve on this board: <br />I desire to assist in the program s that directly affect the aging in my comm unity. <br /> Conflict of Interest: <br /> <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 /> <br />Reasons for wanting to serve on this board: <br />I desire to assist in the program s that directly affect the aging in my comm unity and ensure the <br />well being of those in placement. . <br />Conflict of Interest: <br />12