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/8 <br /> <br />P ~ oF~ <br />ORANGE COUNTY RESIDENTS APPLICATION Marx 6insbe~~- <br />COUNTY BOARDS AND COMMISSIONS <br />/C• /~Iff~k'__C.~/~+/S$E/ZC~---- -------- Date:__~/3L_97------ <br />Name: <br />;3treet•_ Z 7z o _ ~R/~7Fl~LD -RD---------------------------------- <br />Town•__H/~L5~3~~oNGh/--_ <br />-------- Z ip:__Z 7 z 7B'-- --- <br />Telephone: Day: ~~7' ~i93 ..._~ Evening: 73 a " y6 z L <br />Ethnic Background: Afro American_~ Caucasian____`~ ____ <br />Native American ~ Other____l__________ <br />Male '~ .Female Date of Birth 9//y~~L <br />Occupation:__ ~~i/~C~~i2_--G.¢R~~i/ ,o,q/,/Tin/Cr~Au,~ltft~"l __--~- <br />Community Interests and Activities: C6Miy !~N /7' _ C yt/.eG o~ G#r3P_._.. L ~/LL' <br />Socl~t, con/c~,2n/S ~ coF~EE O~dS~ /~RODuGT~°~/ Cd~~ / ~~~ CMEM#3ti2.~ ~ Cl~Ai12~- <br />_n~_o~r/_n/R ~ion/AL ~FFA/~?S Co-fov~/v~' o/= (.~N~r/J,¢~yn1 ~Ni Vc:'r?S~wST_can/be~lf, <br />o F r-(IL ~s 8 aRd u G N ~ E.~c ~~ o.J iN r~.~rT.9.7-i cv+/~ c. s ~~'~~! I r~~r-- c o h ~i i 9T t~~c~ ~ ~ <br />uu n/ET'wo,4K o~/ /~/vlCr~ifovtS ~I'_F/-rfi/e~SC'/A~TfV~ RM~~141-n~ Can~c~„rS~/G/~E,~~ <br />j~o~i~~"fiTT:~so~~,t~, w~tc.~~B.¢vU Y'R~4~cf~ETB~wf'~ctJic%~~--_------ <br />Township of Residence: <br />r Grove _~_~.Cheeks , <br />___ B gham Ceda <br />_ __Eno Chapel Hill ~ Hillsborough <br />Little River Do you reside in the extraterritorial area of a municipality <br />. yes no ~~oSs /~3 ~Y) <br />"~ Please list in order of preference Boazd/Commission(s) on which you k <br />. , would like to serve: R ~ ,~~~I <br />n + y~,~,~ B[ ~~1~5~1y4J~ - - ---'-'-------- ---- <br />~~ - ~Sor,~rres Cro 2C, Q ~r~ C T~__P~~!~!n%/~!G _ ~~!~~ _ <br />:~; ~~ L~ --- - -- -- <br />_~F /11L2/~ d b r <br />3•~jI ~AVISoe~-~A._ a~ ~GJnI~_----------- <br />Remarks: IlU~~4_ o.~~coci~s~ T ,eEcE1/~ ~~',eTiFic,~T~-/n/_~/d~l-~,edi /T <br />M~in/~¢GEMrc~/ r ,~iQcM Atlk~ uN~ /. T.B. ~. /tir~/~rio,/A~ R ~~~iONS ~~ <br />cOCiP~~9F~-~ Y~s__c~~~~i¢TE Cov~SE~-.~D,C,~_ /~/ i~vT REL ~ Sac/a~~Gy __ <br />. Si nature: ~ /~ ~~_° ~'r _______ <br />g __----__ ~ ~~~ ----- --- --- <br />~ a~. <br />.:~ Return to: Beverly Blythe ~ ~ ~ a :I' <br />Clerk to the Board of County Commissioners D ~ ~ 'l~ <br />P. O. Box 81a1 ,~;=;~. -' 9 {997 ~~ ~ ~;; <br />Hillsborough, NC 27278 <br />