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G 4 1 <br />• <br />COUNTY OF LEE <br />BOARDS/COMMISSION APPLICATION <br />The Lee County ' Board Of Commissioners believes that all citizens should h; <br />participate in governmental decisions. One way of participating is by serving as a <br />of the county's advisory boards, listed below. If you have an interest in being con: <br />to one of the boards, indicate by placing a check mark by yourlnterest(s), co <br />and mail to the address listed at the bottom of the application. For additional <br />committees or to complete an on-line application, please visit our web site at www.i <br />BOARDS AND COMMISSIONS <br />_ Sanford-Lee County Airport Authority <br />-Americans with Disabilities Act (ADA) <br />Board of Adjustments (Lee County) <br />Board of Adjustments (Sanford) <br />_ Board of Equalization & Review <br />_ Abandoned Cemetery Board of Trustees <br />_ CCCC Board of Trustees <br />_kee County Economic Development Corporation <br />Lee County Fire Advisory Board <br />_ Lee County Environmental Affairs Board <br />Lee County Board of Health <br />Industrial Facilitles $ Pollution Control Financing <br />NAME: _Kt'-yJ Gr/72ETT <br />ADDRESS: alb <br />i <br />HOME PHONE: -7 S - rl S <br />PLACE OF EMPLOYMENT: <br />OCCUPATION: <br />EMAIL: K2U2K~ p _~,g&r CgAXNO._ ZIg- LAr <br />List any experience/qualifications you have relevant to the above board/commiss <br />in. <br />I CERTIFY THAT ALL OF THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE TO THE <br />BEST OF MY KNOWLEDGE. <br />DATE: ' 020 - lYT <br />Signal re of App icon <br />NOTE: MUST BE A RESIDENT OF LEE COUNTY. CAN ONLY SERVE ON ONE (1) BOARD AT A <br />TIME. <br />Return completed application to: Ms. Gaynell Lee, Clerk to the Board of Commissioners, PO Box 1968, <br />106 Hillcrest Drive, Sanford, North Carolina, 27331-1968, or fax to 774-8407 or e-mail to <br />glee&leecountync oov. <br />QC" S <br />owl 4e„ <br />JAN 2.12 q <br />U <br />the opportunity to <br />zen member of one <br />red for appointment <br />ete the form below, <br />ormation about our <br />-Jury Commission <br />_ Library Board of Trustees <br />_ Mid-Carolina Workforce Development Bd. <br />Parks & Recreation Commission <br />Planning Board (Lee Ccunty) <br />Planning Board (Sanford) <br />Rest Home-Nursing <br />Home Adv. Board <br />Senior Services Adviso Bcard <br />Social Services Board <br />_ Transportation Advisory~Board <br />_ Juvenile Crime Prevention Council <br />Criminal Justice Partnership Advisory Bd. <br />WORK PHONE: <br />100 d E 02 (GH1)EOG2 12 9 0 <br />