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1 <br />r <br />Page 1 of 1 <br />Dawn C. Pickett <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 />Job Title: <br />Ms. Dawn C. Pickett <br />107 Jones Street <br />Chapel Hill NC 27514 <br />919-929-8965 <br />919-929-8965 <br />pickettdawn@hotmail.com <br />Township of Residence: Chapel Hill <br />Zone of Residence: At-Large or C.H. city limits <br />Sex: Female <br />Ethnic Background: Caucasian <br />Date of Birth: 11/2/1945 <br />Boards/Commissions applied for: <br />Nursing Home Community Advisory Committee <br />Work Experience: <br />Volunteer Experience: <br />Education: <br />Other Comments: <br />On 10/23/03, she updated her application with staff at CFE; she is still interested in CFE <br />but primarily in NHCAC, 11/25/02 renewed her app. far Nursing Home Community Adv, <br />Committee, 1st choice; CFE, 2nd choice. Applied 2/19/02 for Nursing Home Community <br />Advisory Committee; Adult Care Home Community Advisory Committee; Commission for <br />the Environment, WORK EXPERIENCE: Medical Review of N.C,, Senior Assoc; QVP <br />Projects. VOLUNTEER EXPERIENCE: Wake County Nursing Home Advisory <br />Committee; N.C. Health Access Coalition (see attached letter), EDUCATIONAL <br />EXPERIENCE: B.A, Industrial Relations, UNC-Chapel Hilh addrs.ver,mpqust.ncp, 107 <br />Jones Street is in C,H. city limits, <br />This application was current on: 10/23/2003 Date Printed: 6/14/2004 <br />