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<br />This space for office use only <br />Page 1 of 1 Mary Ann Peter <br />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 <br />time and expertise to your community, please complete and submit this form. <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 />Township of Residence: <br />Zone of Residence: <br />Sex: <br />Ethnic Background: <br />Date of Birth: <br />Ms. Mary Ann Peter <br />118 W. Tryon Street <br />Hillsborough , NC 27278 <br />919-732-6073 <br />919-732-6073 <br />maryannpeter@earthlilnk.net <br />UNC-CH School of Nursing <br />Adjunct Professor <br />Hillsborough <br />Does not apply <br />Female <br />Caucasian <br />07/17/2003 <br />Please list (in order of preference) the Boards/Commissions on which you would be <br />willing to serve. 1. Nursing Home <br />Community Advisory Committee 2.Advisory Board on Aging 3. __ <br />Work Experience: Director of Nursing -Duke Hospital (1980-1951): Director of <br />Nursing Duke North; Director of Heart and Emergency Nursing, Dir. of Medical Nursing. <br />Faculty -UNC - CH School of Nursing (1991-2001)-Adjunct Professor. <br />Volunteer Experience: Durham Technical Community College Board of Trustees, 15 <br />years to present. American Heart Association - 10 years; Orange County Historical <br />Museum Board of Directors - 1 years; Walkable Hillsborough Coalition - 1 year. <br />Education: BSN, MSN -Duke University; PhD, UNC -Chapel Hill <br />Other Comments: <br />How did you become aware of Orange County volunteer opportunities? <br />Current Orange County Volunteer. <br />By submitting electronic application, applicant agrees to Ethics Guidelines and agrees to <br />attend three-hour orientation. <br />This form was submitted online, on 2/4/03 3:19:20 PM <br />