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.- ... D _ <br />~.~ <br />• FOR OFFICE USE ONLY ;~ • <br />'t <br />VOLUNTEER APPLICATION <br />ORANGE COUNTY ADVISORY BOARDS AND COMMISSIONS <br />!f you are an Orange County resident, at least 18 years old, and willing to volunteer your #me and <br />expertise to your community, please complete this application and return to: . <br />Orange County Commissioners' OtRce <br />P.O. Box 8181 <br />Hillsborough, NC 2T2T8 <br />Phone (919)245-2125; 248-2129; 245-2130; 752.8181 <br />_ Fax: (919) 6/44-0246 • Email: nmartin~co.orange.ncus <br />HoMEADDRESS: ~ I i. a' . Fin (e~ F~or~s-~- ~r <br />cITY• C ba pe I ~ N ~ 1(,L h1 ~ Zip C4de:~?5/ 7 <br />PHONE: (Day) 6 ~ a ` a'S°ZJ (Eveningllate) ~ 6 q - ~ ~ 36 (Fax) <br />cMI ~1 nc.rr,co~ <br />ENAtL. _ - <br />PLACE OF EMPLOYMENT: SQ ° r~S Ev-~{.pytyors 1.r,e, JOg ~• c Hskr~er s~, ~,~e.~ge:~t- <br />. ~ tN ORDi'=R TO ASSURE COUNTYWIDE REPRESENTATION PLEASE INDICATE YOUR TOWNSHIP• <br />OF RESIDENCE: <br />• ^ t3fngham ^ Cheeks D Hillsborough D Eno 6~Chapei Hitt D Little River D Cesar Gro:re <br />IN ADDITION,~PLEASE INDICATE IF YOU LIVE IN ONE OF THE FOLLOWING AREAS: <br />D Joint Planning Area D Extraterrita~rial Area D Transition Area <br />- WB ASK YOUR HELP IN ASSURING DNERSITY OF MEMBERSHIP BY AGE, GENDER AND RACE, <br />BY ANSWERING THE FOLLOWING QUESTIONS: l~tVlale CI Female. <br />~~ ~ .. • ~ ETHNIC BACKGROLND:~ ^ African American G'1(Caucasian~ fl Hispanic ^ AmsrKan- ~ ~~ ~ - <br />. D Other ~ DATE OF BIRTH: ~1g a9 rj,~ <br />PLEASE UST (W ORDER OF PREFERENCE) THE BOARDSlCOMMISSIONS ON WHICH YOU <br />wouLD BE wt NG TO SERVE. <br />1, ABC ~o~,r ~ 2. PerSo~hef ~¢dy~SyrcrBoar~S, A9lr;cK/~ra~ Pr~se~„/R~chBv. <br />WDRKEXPERIENCE: ~.SPOrfs ~+-deavors enc. /H;llsdorotiq~,NGlCMS~it~i-Serv.`cP~4~ent <br />• x T ocv(/r-- 7rn~UwN <br />~ fir, PO t; Lee 1~oWklnd. I <br />~ 6Ji ng g~ l~nirersi-~-Y Ga ~ <br />~_ <br />VOLUNTEER EXPERIENCE: <br />~~r l;`,~ Mo~ris~ifl ,vc <br />Rece fknist 0{~i'ce MRhq <br />_ ~OS-I' Phi fe (Y.~in~q•~PrF <br />~w :CO ~~O.Q nf71 ~m.o..~-•~ <br />Restrra~rbh 5~ le~s A Bnf Ma rtli aAO/-S <br />• a~~ nc at~o-~ i sb, ac~l <br />Worts S•llnclY lR H 9 l9gsr HqY /997 <br />7~Nic~ l~errq~ -~~il'e venq~ (.AMR*9Y~ ~IV~r~~/~~ 4 <br />~ Robeson Cd~nfr /ctrl-c pe,Fa1der.; o,A;'re ~t~,~e••t <br />~ lvc . qn,-~F~e,~ aoa <br />/ TN ! -- Nai , I g9~ <br />ti N .Tune- ~`,9~ /9 <br />