Orange County NC Website
Browse       Search
i <br />., D <br />FOR OFFICE USE ONLY ` ~~ <br />' 1 ~ oL ~ ~~tE~ <br />I ol=d <br />• Cha~rl;~.~~ ~ <br />VOLUNTEER APPLICATION '~~ __.. <br />.ORANGE COUNTY ADVISORY BOARDS AND COMMISSIONS <br />If you are an Orang® County resident, at least 18 years olds and wiping t4 volunteer your time and <br />expertise to your community, please complete this application and return to: <br />Orange County Commissloner~' Otllce <br />P.O. Bax 8181 <br />Hlllsborough~ NC 27278 <br />Phone (919) 245-21?„S; 2gg.2129; ?45-213p; 7S2,g181 <br />Fax: (919) 644-0246 • Email: nmartin~co.arange.ncus <br />HOME ADDRESS: ~ !. a' . F• n le Fo ~sf - ~P, <br />clnr. ~ C ka pe I N~ I ~, w~ Zip code: ~5l ~ <br />PHONE: (Day) 6 ~a ' a~o~J "~ <br />. -.-~(Evening/late) ~69-836 (F~) <br />EMAIL: GMI hc.rr.COlh <br />PLACE OFEMPLOYMENT; -s ~ h~5' F-Y-~(pAVOrs' :u,c, JOB TITLE: c K.t~aw~'r Sir v,e~. <br />~9e:~i- <br />!N ORDER TO ~-SSURE COUN7'YWID>;~ REPRESENTATION PLEASE INDICATE YOUR TOWNSHIP <br />OF RESIDENCE: <br />^ Bingham D Cheeks D Hgisborough p Eno @t'Chapet Hill d Little Rhrer d Cedar Grore <br />IN ADDITION,~PLEASE INDICATE IF YOU LIVE 1N ONE OF THE FOLLOIMNG AREAS; <br />^ Joint Planning Area ~ Extraterritorial Area ^ Transition Area <br />WE ASK YOUR HELP IN ASSURING DNERSITY OF MEMBERSHIP BY AGE, GENDER AND RACE, <br />BY ANSWERING THE FOLLOWING QUESTIONS: I~Male D Female <br />.. ~ ETHNIC BACKGROl1ND: ~ Others AmericanDATE OF B~ Hlspanic~O ~ American- ~ - <br />17TH. • +? 73 <br />PLEASE L15T (IN QRDER OF PREFERENCES THE BOARDS/COAgM15510NS ON WHICH YOU <br />WOULD BE WILLIN~i TO SERVE. <br />1, 19BC ~pq_rd !~ 2, Po~..r5 0~ he.~ ~d y~Sar Boer <br />5r~_~3.~~-~Hl~tr9~ Ph°se~ rW ~1/7cA Bv~ <br />. WORK EXPERIENCE: ,~s or~$ F+-deavor.S ~y,c. -;//s~oroti NG Cns{~j,~,f~rV~~~ ent <br />Sc'. . ~DO~ ~MiGI'w f};r /,` ~1o~ri1~.'l/e PVC Res~rra~rbri S~)es A en f- Ma ~c~ aoa/-s <br />~ Or ~o ~ Lee I~awMnd NG Rece {?cn~f D{1Scc Mghq er TNne dGbO--I=Eb,aG~l <br />~` ~t/i11'q~p. Ign~r2rs- GerM uS P05~ ~ (e Y~in~q~E /JG Worn Sfi,~c1 ~4N /94-5"H9 /997 <br />VOLUNTEER EXPERIENCE: ise->~ Rov-~ Pro •ect' Raw/~A NG q ,--~~~ a~ <br />i`' Nick Re rra.s S~Cr Sehq-~ CAwi ai Nor / ,7'u I -- Nav I g9' <br />~ Robeson CvNn PN~Ir'c Deriders 4~i'ce ~~e~t~ N rune-,~}u <br />/9 ~ <br />