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i~ <br />Page 1 of 1 Peggy Cohn <br />- Volunteer Application <br />Orange County Advisory Boards and Commissions <br />Name: <br />Name Called: <br />Home Address: <br />Phone: (Day) <br />Phone: (Evening) <br />Fax: <br />Email: <br />Place of Employment: <br />Job Title: <br />Township of Residence: <br />Zone of Residence: <br />Ms. Peggy Cohn <br />Peggy <br />10 Bayswater Place <br />Chapel Hip NC 27517 <br />919-489-6624 <br />same <br />peggyoohn1 ~earthlink.net <br />retired <br />Geriatric Can: Manager <br />Chapel Hill <br />C.H. City Limits <br />Sex: Female - <br />Ethnic Background: Caucasian <br />Date of Birth: 8/28/1938 <br />BoardslCommissions applied for: <br />Nursing Home Community Advisory Committee <br />Work Experience: <br />Community Health Nursing educ~ifior UNC and Penn State University <br />Director of Family Ties, Geriatric Care Management, State College PA <br />Volunteer Experience: <br />Nursing Home visitation <br />Non profit Boards in PA <br />Education: <br />BA, vmllesley <br />BSN, Columbia Un'nrersity <br />MPH, UNC <br />PhD, Penn State University College of Health and Human Developmenet <br />Other Comments: <br />STAFF COMMENTS: Originally applied for Adult Care Home Commun'dY Advisory <br />Comm'~ttee and NHCAC and Adv. Board on Aging 10/10/2005. ADDRESS <br />VERIFICATION: Mailing address. listed above. Residence is 233 McCauley Street in <br />Chapel Hill city limits. <br />Tnt: sppUeatlon was cumsnt on: ~a~t ~ ~:3a~~ AM Dsa Prtrrtad: srsr2oos <br />