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. -- ... , HOCC~ER . ~,( <br />- -/23/Ej~ ~O.1~2 ton Wilthoit k~ <br />~oa~tr~v~~~~ ~?p~zc~.~xo~r 1 <br />• o~~~~ ca~r~r~ ~so~~s ,A.~r~ co~ssxar~s <br />if Tau are as Qrange County resident, at Least 18 Tea~•s ald, and wiilt~stg to <br />~oluateer Tour time aad expertise Lo Tout community; p,~esse complete and <br />:etura to: <br />NAME: <br />$GHE ADDRESS: <br />TELEPHONE : (W) 7~ ~ ~ ~ / ~~Y' (g j Q ~ - 7 /~ <br />^ +~ r"err <br />PLACE aF EriPLOYI~SENT = ~~ ^' C- <br />JOS TITLE: ~~'" ~2~-~ li'~ ~'~ <br />,.. <br />O 'RSL LIST JOH, VOLUNTEER, AND EDUCATIONAL EXl?EF.ISNCE AND/OR SKILL5 <br />YOV WOULD SE FO& VS ?0 CONSYDER. <br />ORDER TO ASSURE COUNTYWIDE REpAESENTASIQN PLEASE INDICATE FOUR TOWNSHIP OF <br />RESLDfiNCE <br />e~ham ~ Chnaks ~,,,,,,~ <br />Siilsbormugh Eao <br />Chspe; Hill ~~ ~ Little Fi;tver <br />Cedar Grcvo `"""`-'~ <br />~ AS$ YOUB'BELP IN ASSURING DIVERSYTY OF liEK8ER5FIIP SY AGE r GENDER AND RAC$ ~ <br />8Y A~tS~G 1`SR HOLLOWING gVES'xxONS <br />~is~Le - ~..~„ BTRNIC HACSGROUND: . • _• <br />Fe~osle ~~ Afr3ceu Amsriaszr Hispaeiie ,,,,~_ <br />• , . 'Csnca~~an ~ ~ Other ___~__ <br />Natfve Americas ._~ <br />DATE OF BI TS: <br />~ ~`` 3 <br />r irrr..w~r~ r~+~r~.~-r+ - - r+r.~.~ r+r.~~r <br />PLEASE LIST (IN ORDER OF PREFERENCE) 'XHE BOARDS/COHZSI55ION5 ON S~IHIC$ FOiI <br />itOtTLD <br />1. <br />2. <br />s. <br />4. <br />• ...~~.~ <br /> <br />' CauazY Comtmi~sionsrs' Off~tce <br />P. O. Sox 8181 <br />. B~.llsborouSh, .NC 27278 <br />