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i ~.~r/f <br />- VQLUNTEER APPLFCATION ~~ <br />~RA.N~E CQUNTY BARDS AND COMMIS~ZQN'S <br />• ~• - <br />If you are an Orange Cauatp resident, at least 18 gears old, and willing .to <br />volunteer pour time and expertise to pour community, please complete and <br />return to: <br />NAME: ' <br />HOME ADDRESS: <br />' Caunty~Commissioners' Office <br />P. 0. Box 8181 <br />~ Hillsborough NC '27278 <br />C <br /> <br />ip Cede <br />TELEPHONE : (~') ~'~ 4 `~C0 ~ (H ) <br />PLACE OF EHPLOYMENT: ~-~ ~~~ ~ ~ ' <br />JOB TITLE : _ ~ C,l}1-LQ/l- --1'VIC~.d ~~ , <br />v <br />ON REVERSE SIDE LIST JOB, VOLUNTEER, AND 'EDUCATIONAL EJ~PERIENCE AND/OR SgILLS <br />YOU WOULD LIRE FOR US TO CONSIDER. <br />ORDER TO ASSURE COUNTYWIDE REPRESENTATxON PLEASE I1~DIGATE YOUR TOWNSHxP OF <br />RESIDENCE: <br />Bingham Cheeks -_.~.-- <br />Hxllsborough Eno ~- ' <br />Chapel Hill Little River. ._~_ <br />Cedar Grave <br />'WE ASS. YOUR WHELP IN ASSURING DIVERSITY OF t~ERSHIP BY• AGE' GENDER AND RACE; <br />BY ANSWERING THE FOLLOWING QUESTIONS: <br />Male ~ ~._ ETSNIC BACKGROUND : - Sispaaa.c .~_ <br />Female ~^ Africa.a American <br />• - • 'Gaucas~.sn ~ Other _,-_.-.- ~ . <br />Native pmeri.caa ~, <br />DATE OF BIRTB: • <br />-PLEASE LIST. (IN ORDER OF PREFERENCE) T~ ARDS/COMMISSIONS ON W~iICH YOU <br />WOULD BE. SjILLING TO SERVE. (~ L~ c,-~~. <br />1. C ~ L <br />• 0 1~ C ~Ys G~ f _~ {{ <br />-I..ekll Q. M 1.1 ts'~4s~ ~ ~~K• ~ -- ~ <br />