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_. -.~ <br />03/10/1999 22:04 9197324524 AYR MQUNT PAGE 01 <br />Msr~11 98 09~13e Buck Tr•edw0y X9381 6~~-Oc~$ <br />3/~ x/99 P- I /2 di I ~ Crv u~~he r <br />VOLUNTEER APPLICATION <br />OftANGt: COUNTY 80ARDS AND CQMMISSIQNS <br />If you are an Onnus County resident, at Ieasc 18 years oid, and willlno to vofunti0r Yvgf timtr and <br />expertise to your communlt3-, plepse complete and return to: <br />Orange Ceunty Comenlssionwrs' OtRce <br />P. 0. t3ax ata~ <br />Httlsborouph, NC zi2Ti <br />NAME: ,,.,,fit CRyt~u H E R <br />Mo>teE AooRESS: 3~ ~ St. YID tRRyS R,0 ~..._____ <br />~tLl,SQoleougN Zip Cede ~T~78_ <br />TELEPHONE: (N) 1.31• 53 7 (Fax) 73~. ys a~( <br />w <br />RLACE OF EAAPLOYMENT: Rye IMDl3tJT <br />Jos TI1'Lifi; _ S ~tE ~ ~ ~ . <br />ON 9~~Ubt dOQ, VOLUNTEER, AND EDUCATIQNAL E7(PERIl=NCE ANDI'OR SKILLS YOU <br />Lo E S 70 CONSIDER. <br />iN ORDER t0 A8SUR$ COUNTYWIDE Rl:PRl;SENtAl'IpN PLEASE INDICATE YOUR TOWNSHIP OF <br />RESipENCE: Bingham ~,~ Cheeks ,_„~,~ <br />Mtilsborvuph ~y Eno ~,,,~ <br />Chapel HIII _,_„_,~ Little River ~,,,`~ <br />Cedar Orove <br />IN Ab01Ti0N, PLEASE INDICATE IF YOU LIVE IN ONE OF tHE FOLLOWING AREAS: <br />JPA (Joint Planning Arse) <br />EA (lactraterritvrial Area) ~ <br />rA (Transition Ares) <br />WE ASK YOUR HELP IN ASSURING DIVERSITY OF MEMBERSHIP 8Y AGE. GENDER AND RACE, 8Y <br />ANSWERING THE FOLI.OWINti QlJESTIONS: <br />Male ~_ <br />Fema<N <br />DATE OF BIRtH~ <br />,. )sloe Ise <br />ETHNIC BACKGROUND: <br />African Amerman <br />Cauwrslsn `~ <br />Nlltive American _~ <br />Hbpanic <br />Other _~. <br />PLEASE t,ISY (IN ORDER OF PREFERCNGL~ THE BOIfRD$fCppIMIS3iONS ON WHICH YOU WOULD <br />BE WtI.LING TO SERVE. - <br />i. E ~ R BQp~ <br />T. __~1il~porg~ ~.' ~ ~cr'~e~c1t , a p(~. da~e 1 t - (e ^ D 1 <br />3. <br />Renev~c~ on I Z ~ v ~ a <br />