Orange County NC Website
Browse       Search
rirK 24 2003 12: 41 PM <br />P t of z <br />FOR OFFICE U5E OILY <br />~~ <br />_ _~~ ... . - 3. -- - •- ~ -- <br />VOLUNTEER APPLICATION <br />ORANGE COUNTY ADVISORY BOARDS AND COMMISSIONS <br />ff you are an Orange County resident, at least 18 years old, and willing to volunteer your time and <br />expertise to your community, ploass complete this application and return to: <br />Orange County Board of Commissioners' Office <br />P.O. Box 8781 <br />Hillsborough, NC 27278 <br />Phone X919) 2452123; 245.2729; 24~-2190; 73Z-818) <br />Fax: (918) 6440x46 -Email: ncgloverQco.orange.nc.us <br />NAME: Cahrclf LEwj~ ~~w1C~°~-_ <br />HOME ADDRESS: ~~tl Sw~`F ~8 ~ fi ~- c~ A~'~ _ <br />•-7---• ._._ Zip Code: /Z •Z ~ - <br />PHONE: (Day) S19~73~ / .?.Z (Eveningllate) S ~~~~__.. (per) <br />EMAIt.: _-~ awkL~r '' M~i Nd SP1~i ~ 9 ~ Cn w ___. <br />PLACE OF EMPLOYMENT:~~s~ Gu :•~CirtS~r4~ _ JOB TITLE: <br />IN ORDER TO ASSURE COUNTYWIDE REPRESENTATION PLEASE INDICATE YOUR TOWNSHIP <br />OF RESIDENCE: <br />D Bingham O Cheeks O Hillsborough ^ Eno O Chapel Hill O Lithe River~Cedar Grove <br />IN ADDITION, PLEASE iNDICATE IF YOU LIVE IN ONE OF THE FOLLOWING AREAS: <br />D Joint Planning Area O Extraterritorial Area O Tran9iiion Area <br />WE ASK YOUR HELP IN ASSURING OIVERSfTY OF EMBER3HIP BY AGE, GENDER AND RACE, <br />BY ANSWERING THE FOLLOWING QUESTION :Male D Female <br />ETHNIC BACKGROUND: O African American Caucasian O Hispanic D Native American <br />O Other DATE OF BIRTH: _ i_~- <br />PLEASE LIST (!N ORDER OF PREFERENCE) THE BOARDS/COMMISSIONS ON WHICH YOU <br />WOULD BE WILLING TO SERVE <br /> <br />WORK EXPERIENCE: S'v r u <br />1 t ~~ r..~,i'. _ <br /> <br />r w <br />NTEER FaCPERIENCE: <br />~ ~P <br />(919) 544-0246 <br />s 'N ct~t„J{c.i aS <br /> <br />~,~. ~vn <br />~_~iI s 1so r~ <br />_' ~ ~ ~c~ . -------- <br />EECEIVED 04-24-~ A2 ~ ~ • c~ rrnnn _ . _ <br />ORR(YGE COUNTY HOCC <br />~~ <br /> <br />Ti~.t ~p; <br />i3 <br />