Orange County NC Website
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~ ~ g/9g. ~ -P. ~ o r 2 R~ cl~a~~ 1iV . Pr-a ~1" <br />~,`,,~;} VOLUNTEER APPLICATION <br />.~_ <br />ORANGE COUNTY BOARDS AND COMMISSIONS <br />If you are: an Orange County resident, at least 18 pears old, and willing to <br />volunteer your time and expertise to pour community, please complete and <br />return to: <br />County Commissioners' Office <br />P. 0. Box 8181 <br />NAME: <br />HOME ADDRESS: <br />Hillsborough NC 27278 <br />~. ~-, ~- <br />,~D <br />~8 ~.-t~~~~z t7 ~~ <br />C~l~t, j{•!l~ , NC.. Zip Code 27~+~~ <br />TELEPHONE : ( W ) ~«-.~pg_ ~~~` ( H ) ~ 4 ` '~' OQ~ ~ <br />PLACE OF EMPLOYMENT : ~~ ,~ .~~- ~ - , <br />JOB TITLE: ~SEN+o~2- (:.d`uS~a~i7f~(T <br />?'"REVERSE SIDE LIST JOB, VOLUNTEER, AND EDUCATIONAL EXPERIENCE AND/OR SKILLS <br />~~'U WOULD LIRE FOR US TO CONSIDER. <br />IN ORDER TO ASSURE COUNTYWIDE REPRESENTATION PLEASE INDICATE YOUR TOWNSHIP OF <br />RESIDENCE: ~ ' <br />Bingham ~ Cheeks <br />Hillsborough Eno <br />Chapel Hill ~ Little River <br />Cedar Grove <br />WE ASK YOUR HELP IN ASSURING DIVERSITY~OF MEHBERSHIF BY AGE, GENDER AND RACE, <br />BY ANSWERING THE FOLLOWING QUESTIONS: <br />Male ~~ ETHNIC BACRGROUND: <br />Female African American <br />' 'Caucasian <br />Native American <br />DATE OF BIRTH: <br />2 ~~ ~G <br />Hispanic <br />Other <br />PLEASE LIST (IN ORDER OF PREFERENCE) THE BOARDS/COMMISSIONS ON WHICH YOU <br />.WOULD BE WILLING TO SERVE . ~ ~, ) ~ S"~ ~/ `~(~~ N to~y~/9 ~~. <br />s'(nN~TCSrnx Trnit ~rn Fl~**.lT4nl~: +~ <br />3. <br />4. <br />