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VOLUNTEER APPLICATIO <br /> COUNTY BOARDS AND CO s� I M <br /> ANGE <br /> f you are an Orange. County resident, at least 18 years olas -an w <br />•olunteer your time and expertise to your community, please complete and <br />•eturn to: <br /> County Commissioners ' Office <br /> P. 0. Box 8181 <br /> Hillsborough, NC 2 72 78 <br />(AME: <br /> i Te N�4 <br /> OME ADDRESS : \ <br /> AL C-- zip Code ' <br /> ELEPHONE: (W) <br /> H) — <br />'LACE OF EMPLOYMENT: n 1 — 1A <br />'OB TITLE: . <br />►N REVERSE SIDE LIST JOB, VOLUNTEER, AND EDUCATIONAL EXPERIENCE AND/OR SKILLS <br /> WOULD LIKE FOR US TO CONSIDER. <br />:N ORDER TO ASSURE .COUNTYWIDE REPRESENTATION PLEASE INDICATE YOUR TOWNSHIP OF <br />.ESIDENCE: <br /> lingham Cheeks <br /> lillsborough , . Eno <br />,hapel Hill ' -- wol Little River <br /> cedar Grove �N-r1P( D- - <br /> TE ASK YOUR HELP IN ASSURING DIVERSITY'OF MEMBERSHIP BY AGE-, GENDER .AND RACE, <br /> lY ANSWERING THE FOLLOWING QUESTIONS: <br />(ale ETHNIC BACKGROUND: <br />'emale _ African American Hispanic <br /> Caucasian Other <br /> Native American <br />)ATE OF IRTH: <br /> sell r ,-3 T <br />'LEASE LIST ( IN ORDER OF PREFERENCE) THE BOARDS/gCO FISSIONS ON WHICH YOG�e,� <br /> TOULD BE WILLING TO SERVE. <br /> y sue' <br />