Orange County NC Website
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t <br /> VOLUNTEER APPLICATION <br /> ORANGE COUNTY BOARDS AND COMMISSIONS <br /> If you are an Orange County resident , at least 18 years old , and willing to <br /> volunteer your time and expertise to your community , please complete and <br /> return to : <br /> County Commissioners ' Office <br /> P . 0 . Box 8181 <br /> Hillsboro h C 7Z ? 8 <br /> NAME : <br /> HOME ADDRESS : <br /> e- 4d&1A= %&AA Zip Codev�a43/_ : oTl <br /> TELEPHONE : ( W 0" o ( H ) 0 <br /> PLACE OF WLOY?4ENT : <br /> JOB TITLE : l _ <br /> ON REV,gRSE SIDE LIST JOB , VOLUNTEER , AND EDUCATIONAL EXPERIENCE AND / OR SKILLS <br /> U WOULD L = FOR US TO CONSIDER . <br /> IN ORDER TO ASSURE COUNTYWIDE REPRESENTATION PLEASE INDICATE YOUR TOWNSHIP OF <br /> RESIDENCE : <br /> Bingham Cheeks <br /> Hi l l s bo rough Eno <br /> Chapel Hill Little River <br /> Cedar Grove <br /> WE ASK YOUR HELP IN ASSURING DIVERSITY '" OF MEMBERSHIP BY AGE , GENDER AND RACE , <br /> BY ANSWERING THE FOLLOWING QUESTIONS : <br /> Male ETHNIC BACKGROUND : <br /> Female African American Hispanic <br /> Caucasian Other <br /> Native American <br /> DATE OF BIRTH : <br /> //& Aa� <br /> PLEASE LIST ( IN ORDER OF PREFERENCE ) THE BOARDS / COMMISSIONS ON WHICH YOU <br /> WOULD BE WILLING TO SERVE . <br /> } .� S je9 ► c PRESEW�t-�i eA) � c0Nk15s1d N <br /> 3 . <br /> 4 . <br />