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ORANGE COUNTY RESIDENTS APPLICATION M ArK G1r?s1X,1 <br />COUN'T'Y BOARDS AND COMMISSIONS ?/ l <br />CTIIJS6; o /RCf. r Date : __1_/3L-g Name: "' 1L ----------------- -------- <br />R/''1 FI ?? D RD. -------------------------- -- <br />a tr e e t:-.17 z o --------------------- <br />HI?LSOVA04C-rH - ------- Zip:- Z-77, ------- <br />y6 ? <br />'' G/77- 2/93 :. " - <br />Telephone: Day: Evening <br />AmericaCaucasian--- ? ____ <br />Ethnic Background. Afro Other______________ <br />Native American <br />' Male _V/ Female Date of Birth <br />1 <br />- ?! i?? G-??2 - c ?¢R? ?i+? ,0,4/?? Ti nl G- Dutlt?•? <br />Occupation:____ -------------------------------------- ------- <br />C6FrM ?/ T C 6/.2G op Gffdt'lle <br />Community Interests and Activities: ,,rEM6? Cff?1/?? <br />-5 *CIA / 7r?FS C <br />G co„rcE,2n/S co>=?EE O?S? P.40DuCt "Al C0/4 <br />UN/rflQ i9!? ?N? V "AgS `_??S CM16-C.?&f <br />'? n?o?r/n/rt ?ion/AL .4?FFA/?S ?Cp-Fcv,JD?L' or <br />of r-fIL?s8aR0uGN?E???' o.?l iNr ?T?}ria?A?- f&?'rf f4l. cadc?S?/aIEEX? <br />U /verwa,,ex oN/ txpiCr61at 5, AF/?Alles?i?f?TIV? <br />Township of Residence: <br />B' ham <br />g <br />Eno <br />Little River <br /> <br /> <br />-,Cedar Grove <br />------Chapel Hill <br />-Cheeks <br />P Hillsborough <br />Do you reside in the extraterritorial area of a municipality <br />-yes --no rPoss /$ eY) <br />Please list in order of preference Board/Commission(s) on which you ?? <br />would like to serve: 4'' g <br />s 2C' QrL?? c <br />t7A <br />3.? ------- ------- ------ <br />E T ?EcEI? c6AT/F1ct_T4_LA/ Alb A(-O,eOi ?T <br />Remarks: 7 <br />ztr!_?- DGlk?' c,(,vt? j1P iHTF??r/o?/.9G-g9TiONS7- <br />M,;,?,¢GE?C? T ?Qa? S CIJa 1,V IN7 R L . ? S0410" Cry <br />-------------- <br />corrPc.?7E?_ Y,4S__C B?vC?? Coa? -------------- <br />?„?:-ter <br />Signature: <br />Signature: <br />/ ?- - <br />- <br />r?ra?r?nMf?,?:. <br />Return to: Beverly Blythe Commissioners . <br />Clerk to the Board of County <br />P. O. Box 8181 <br />Hillsborough, NC 27278 <br />