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This space for office use only ! O 1/20/02 Page 1 of 1 Vidya (Diya) Goli I VOLUNTEER APPLICATION ORANGE COUNTY BOARDS AND COMMISSIONS If you are an Orange County resident, at least 18 years old, and willing, to volunteer your time and expertise to your community, please complete this application and return to: Orange County Commissioners' Office P.O. Box 8181 Hillsborough, NC 27278 Phone (919) 245-2125; 688-7331; 227-3031 FX (919) 644-0246 NAME: -------------------------------- Vidya (Diya) Goli HOME ADDRESS: ------------------ 213 Kenan, UNC CITY: ----------------------------------- Chapel Hill STATE: -------------------------------- NC ZIP CODE: ---------------------------- 27514 TELEPHONE: (Home) -------------- 914-1246 TELEPHONE: (Work) -------------- TELEPHONE: (FAX) ---------------- EMAIL: --------------------------------- golf@email.unc.edu PLACE OF EMPLOYMENT: ------ UNC JOB TITLE: --------------------------- student TOWNSHIP OF RESIDENCE: ---- Chapel Hill ZONE OF RESIDENCE: ------------ Does not apply SEX: ----------------------------------- Female ETHNIC BACKGROUND: --------- Asian DATE OF BIRTH: -------------------- 01/14/1984 LIST, IN PREFERENCE, THE BOARDS/COMMISSIONS ON WHICH YOU WOULD BE WILLING TO SERVE: 1: ---------------------- Board of Health 2. ------ Human Relations Commission 3. ------ Commission for Women Please list work, volunteer and educational experience. WORK EXPERIENCE: 1. Intern, 6/00-8/00, Southern Testing and Research Labs ('Wilson, NC), liaison between lab technicians and instrument operators and secretaries and group leaders, recording and assessing data, keeping track of new and used chemical reagnets, assisting with lab work, clerical work. VOLUNTEER EXPERIENCE: 1. Member of Youth for Elderly Service, Campus ~' (UNC), 8/O1-present; retirement home companion to elderly people at Carolina House retirement home.2. Carolina Cancer Focus Education and Fundraising Committees, 8/98-present3. AID-UNC (Association for India's Development) Co- Founder and Treasurer, 1/O1-present; organizing projects and upcoming SK race to raise awazeness and contribution to projects against poverty and illiteracy in the poorest parts of India.4. Peer Advisor at UNC, 8/O1- present5. volunteer switchboard operator, NCSSM, 8/99-5/00 communication skills6. Chemistry stockroom/lab assistant, 8/98-12/98; setting up labs and managing lab apparatus(volunteer service required of all students- NCSSM residential school- Durham, NC); organizational and technical skills7. Tour guide, 6/98-8/98, Imagination Station museum (Wilson, NC): clerical, communication skills EDUCATIONAL EXPERIENCE: 1. High School Diploma, North Cazolina School of Science and Math (Durham, NC), 6/5/002. pursuing BS degree in Biology or Biomedical Engineering, UNC-CI:[, 8/00- present, currently in sophomore year OTHER COMMENTS: I have done a lot of service that is non-health related and would really like to do something in the Health field. By submitting electronic application, applicant agrees to Ethics Guidelines and agrees to attend three-hour orientation.This form was submitted online, on Sun Jan 20 17:43:53 2002