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33 <br />This space for office use only <br />09/12/01 Page 1 of 1 Jeffrey A. Kueffer <br />VOLUNTEER APPLICATION <br />ORANGE COUNTY BOARDS AND COMMISSIONS <br />If you are an Orange County resident, at least 18 years old, and willing to volunteer your time <br />and expertise to your community, please complete this application and return to: <br />Orange County Commissioners' Office <br />P.O. Box 8181 <br />Hillsborough, NC 27278 <br />Phone (919) 245-2125; 688-7331; 227-3031 FX (919) 644-0246 <br />NAME: --------------------------------- Jeffrey A. Kueffer <br />HOME ADDRESS: ------------------ 122 Oldham Place <br />CITY: ----------------------------------- Chapel Hill <br />STATE: -------------------------------- NC <br />ZIP CODE: ---------------------------- 27516 <br />TELEPHONE: (Home) -------------- 919-960-4800 <br />TELEPHONE: (Work) --------------- 919-998-2336 <br />TELEPHONE: (FAX) ---------------- <br />EMAIL: --------------------------------- kueffer@nc.rr.com <br />PLACE OF EMPLOYMENT: ------ Quintiles, INC <br />JOB TITLE: --------------------------- Senior Director <br />TOWNSHIP OF RESIDENCE: ---- Chapel Hill <br />ZONE OF RESIDENCE: ------------ - <br />SEX: ------------------------------------ Male <br />ETHNIC BACKGROUND: --------- Caucasian <br />DATE OF BIRTH: -------------------- 10/26/1955 <br />LIST, IN PREFERENCE, THE BOARDS/COMMISSIONS ON WHICH YOU WOULD BE WILLING <br />TO SERVE: <br />1: ---------------------- Emergency Medical Services Advisory Council <br />2. ---------------------- Recreation and Parks Advisory Council <br />3. ---------------------- Commission for the Environment <br />Please list work, volunteer and educational experience. <br />WORK EXPERIENCE: 20 years military service: operations, planning, & systems analysis. 3 <br />years pharmaceutical industry: operations, systems analysis. <br />VOLUNTEER EXPERIENCE: Adult leader, Girl Scouts; Habitat for Humanity; Red Cross <br />(blood donations). <br />EDUCATIONAL EXPERIENCE: BS, Public Administration, University of Arizona; MBA, <br />University of New Mexico. <br />OTHER COMMENTS: <br />How did you become aware of Orange County volunteer opportunities? List all that apply: <br />Newspaper. If other, how? By submitting electronic application, applicant agrees to Ethics <br />Guidelines and agrees tn~attend three-hour orientation.This form was submitted online, on Wed <br />Sep 12 07:55:40 2001. ~. <br />