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14 ? <br />FOR OFFICE USE ONLY <br />Z ^Z 2-0 e Io F 2 1?e // ? G. S e <br />iu G-1-UUJ VOLUNTEER APPLICATION <br />ORANGE COUNTY ADVISORY BOARDS AND COMMISSIONS <br />If you are an Orange County resident, at least 18 years old, and willing to volunteer your time and <br />expertise to your community, please complete this application and return to: 2 -- .- <br />D L5 \r !- r,* <br />v <br />Orange County Commissioners' Office <br />P.O. Box 8181 ' <br />Hillsborough, NC 27278 FEB 2 2 2001 IN <br />Phone (919) 245-2125; 245-2129; 245-2130; 732-8181 { <br />I= (991-9) 644-0246 ? .Email: nmartin@co.omnge.na. E <br />NAME: l TN S-ro E <br />-l J <br />HOME ADDRESS: Q 5- SM XTy/V C?' ?Ct?%?U ,tad d J <br />CITY 0 t L LS b o R o U G /v C 21p code: a 7a 78 <br />PHONE: (Day) (Eveningllate) (Fax) <br />EMAIL: 6c'-f PLACE OF EMPLOYMENT: I (? JOB TITLE: 4voer" <br />D ra <br />IN ORDER TO ASSURE COUNTYWIDE REPRESENTATION PLEASE INDIA Y U TO S 1° <br />2 TE• ? R WIC H <br />....OF RESIDEWCE: - <br />? Bingham ?. Cheeks Hillsborough ? Eno ? Chapel Hill ? Little River ? Cedar Groire <br />IN ADDITION, PLEASE INDICATE IF YOU LIVE IN ONE OF THE-FOLLOWING AREAS: <br />? Joint Planning Area ? Extraterritorial Area ? Transition Area <br />WE ASK YOUR HELP IN ASSURING DIVERSITY OF' MEMBERSHIP BY AGE, GENDER AND RACE, <br />BY ANSWERING THE FOLLOWING QUESTIONS: ? Male Female <br />ETHNIC BACKGROUND: ? African AmericanACaucaslan ? Hispanic ? Native American <br />13 Other DATE OF BIRTH: 1 - z` ?-A- <br />PLEASE LIST (1N ORDER OF PREFERENCE) THE BOARDSICOMMISSIONS ON WHICH YOU <br />WOULD BE WILLING-TO SERVE <br />1. ° C 2. 3. <br />WORK EXPERIENCE: Part7tin7e , vs? vas k ea.., 1/•ll6v va4, <br /> <br />I'Aj Nw. <br />Gr•2a7'L/0 /) 14 <br />GY c f yxv Fs , /,•?,? <br />VOLUNTEER EXPERIENCE: --S ?" • /-f , <br />?` G • 4-l?? ISc?u ?S , J <br />0 14 <br />Y•o-?r , <br />Shute /den/fjj Zrbgrr4nc-eP#r mty <br />. Sc