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to <br />Page 1 of 1 <br />Peggy Cohn <br />Volunteer Application <br />Orange County Advisory Boards and Commissions <br />Name: <br />Name Called: <br />Home Address; <br />Phone: (Day) <br />Phone: (Evening) <br />Fax: <br />Email: <br />Place of Employment: <br />.lob Title: <br />Township of Residence: <br />done of Residence: <br />Sex: <br />Ethnic Background: <br />Date of Birth: <br />Ms. Peggy Cohn <br />Peggy <br />1Q Bayswater Place <br />Chapel Hill NC 27517 <br />919-489-6624 <br />same <br />peggycohnl @earthlink.net <br />retired <br />Geriatric Care Manager <br />Chapel Hill <br />C,H. City Limits <br />Female <br />Caucasian <br />8/28/1938 <br />Boards/Commissions applied for: <br />Adult Care Home Community Advisory Committee <br />Nursing Home Community Advisory Committee <br />Advisory Board on Aging <br />Work Experience: <br />Community Health Nursing educator UNC and Penn State University <br />Director of Family Ties, Geriatric Care Management, State College PA <br />Volunteer Experience: <br />Nursing Hame visitation <br />Non profit Boards in PA <br />Education: <br />BA, Wellesley <br />BSN, Columbia University <br />MPH, UNC <br />PhD, Penn State University Gallege of Health and Human Developmenet <br />Other Comments: <br />STAFF COMMENTS: Originally applied for Adult Care Home Community Advisory <br />Committee and NHCAC and Adv. Board on Aging 10/1 Q/20Q5. ADDRESS <br />VERIFICATION: Mailing address listed above, Residence is 233 McCauley Street in <br />Chapel Hill city limits. <br />This application was current on: 10/10/2005 11:34:21 AM Aate Printed: 11/2/2005 <br />