Orange County NC Website
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. /3 <br />- ~' ~ VQLUNTEER A.~'PLIC.ATIaN <br />GRANGE C4•[TNTY BaARDS AND COMMI S S ~aN•S <br />• '- • <br />If you are an Orange County resident, at least 18 gears old, and xilling.to <br />volunteer Tour time and expertise to your commuaitT, please complete and <br />return to: <br />. County ~Comraissioners' Office <br />p. 0. Sax 8181 <br />gi/.J.lsboraugh NC 27278 <br />NAME : /,! ~ 1 ~ Pj/j ~ /~ Ci 7 <br />HONE ADDRESS : ~ ~l~/~'~//~C ~e ~ 4 <br />`I ~ t ~ I/r•9 ~Gf/L~ 2i.p Code~~s~~ <br />. ~ - ~p V ~a~-2., <br />TELEPHONE : (W) `~` ~ 4 ~~ ~ ~ S ~ <br />PLACE OF EHPLOY~ENT: ~-i 7~ ~" ~" <br />JOB TITLE: _ ~ ~''l~'~~' ._~(,~,tit.~L~ ~ •• <br />ONE-E SIDE LIST JOB, VOLUNTEER, AND 'EDUCATIONAL F.SPERIENCE AND/OR SgILLS <br />YOU WOULD LIRE FOR US TO CONSxDER. <br />ORDER TO ASSURE COUNTYWIDE REPRESENTATxON PLEASE YNDICATE YOUR TOWNSSxP OF <br />RESIDENCE: Cheeks ' <br />Bingham <br />gillsborough ~° "''~~C'-~' • <br />Chapel Hill Little River. ~.._. <br />Cedar Grave <br />'WE ASK YOUR'HELP IN ASSURING DIVERSITY OF l~EMBERSHTP BY• AGE' GENDER AND RACE; <br />BY ANSWERING TSE FOLLOWING QUESTIONS: • <br />Male ~ ETxNxC BACgGROUND : - gispan,i,c ~.- <br />Female ~_.., African Aaeeriean <br />• ~ 'Gaucasa.an ~ Other _,-._.~ ~ . <br />Native Ameri.caa _~. <br />DATE OF BYRTS:(~ <br />.PLEASE LIST (IN ORDER OF PREFERENCE) THE ARDS/COHMISSZONS ON WSICH YOU <br />WOULD BE. SjILLxNG TO SERVE. ~~ V~'~~~ <br />~. , C ~- <br />~. ~' rte. u~~. <br /> <br />