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ORANGE COUNTY RESIDENTS APPLICATION MgrK 6insber~. <br />COUNTY BOARDS AND COMMISSIONS <br />Name:_ /C•_/LI ~/l' ~/nl..S$EIZC-~---------- -- Date:_ ~ ~___--- <br />~~ _ __~_ _ _y 31.9 <br />r: <br />~ ~ ~~3treet:_ a7zo_ ~•~Z/L/l~l~~D wRD-----------------------------____-- <br />Town:__HI~LSBu,2oNlrM---------------------- Zip• _Z7Z ~B'-- --- <br />_ •- -- <br />~. Telephone: Day: 4/77 ~~93 ,Y Evening: ~3 ~' " ~6 z ~'" <br />~: Ethnic Background: Afro American Caucasian___ ~ ____ <br />Native American Other____________ <br />.~ -_ <br />. i 1~ / <br />~=~~ Male ~ .Female Date of Birth 9/ (~Z <br />. Occupation:__ ~?/Ii/if-G'~~2_--C!¢Rl~~i/ ~,q/'J Tin/Cr~DW'P/t~M ------- <br />.:., <br />..~ <br />°x~ Community Interests and Activities: Co~`'rM uN /7" ~ C f/tleC ~~ G~i`rfGL~ <br />Socr~t, conlc~,¢•n/S ~ colG'I~EE ou.IE PRa~uGrie~t/ Cd~M/Tr~Es ChEri4r'~-~ C/~A/~2- <br />dEn_~a~r/~/~ ~ioi/iPL r4FF.9//?S Co-F'ov~/v~ or uNiTA•2~~ ~N~ Vc~'i~'r~~!ST ~c_o_n/b,~~lf, <br />€~ OF FfILLS$a/eouG~~E.•e~ o~/ iN7'~.ErT.p77cr~/yc. s~~cr'r(Ir~G~cari~i/7Tt~~ ~~ <br />`~ uu n/ETwoak o,/ /~lvtCr~i~o~ ~tFi=~ri~.sC'~/~•~rv ,~MGa-cr,/ ca~~w'~rs~/~CEX~ <br />~'0~~-~~fi~i~i~so~'~it~~- w,g~~}~BA~v~ ~~i9~~.E?B,gw~MKlic%~~--_------- <br />' Township of Residence: <br />•~ ~. Cheeks <br />M~B gham Cedar Grove __ <br />~;:.:: . <br />__ __Eno Chapel Hill ~ Hillsborough <br />Little River <br />_.~~ <br />'~ Please list in order of prefe <br />w: , would like to serve: ~` <br />` ~ y~'~ G~~an~S~ ~Jl <br />tid~i` eSavzes <br />c°~4 lCo~e <br />'~~ 1~1L2/Y db~ <br />Do you reside in the extraterritorial area of a municipality <br />yes no (PoSsI$~y) <br />rence Board/Commission(s) on which you <br />Remarks: zlrl~~~_ ad~COcJ,2S~" To ,QEcE1/~ cE~TiF/~.tT~ ~~/_Na,J-P~di/T <br />- --- <br />MR./~ CrE~ ~.~ r ,~i? a r - Drlk~ G!N t /. ld ~. /N TE~./•~ 7'/o,~/sl G ~ ~ifTi4NS /T -- <br />.. CO/'f PL~7FD _ ~ yes=_~8~ vitTE co rr~s ~~cc,~_ /,/ ~,vT. REL . ~ sac /ate oGy _- <br />Si nature: ~ ~ KJ ~ ~~" ______..___ ~. <br />g ------- ~ ~~~ - ---------- <br />c~ ~. <br />Return to: ~ Beverly Blythe 0~-- :!; <br />-:~ ~~ <br />Clerk to the Boazd of County Commissioners D ~~ ~ i'~ <br />P. O. Box sisl ~;=;'. -' ~ {99~ '~ { ' <br />Hillsborough, NC 27278 <br />