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Rx Oate/Time JAN-30-2009(FP.I) 13:47 9197710758 P 001 <br />01/30/2009 15:21 FAT 9197770758 ERA A1IMONS REALTY Z001 <br />G!0 <br />0 <br />COUNTY OF LEE <br />BOARDS/COMMISSION APPLICATION <br />The Lee County Board of Commissioners believes that all citizens should have the opportunity to participate <br />in governmental decisions. One way of participating is by serving as a citizen member of one of the county's <br />advisory boards, listed below. If you have an interest in being considered for appointment to one of the <br />boards, indicate by placing a check mark by your interest(s), complete the form below, and mail to the <br />address listed at the bottom of the application. For additional information about our committees or to complete <br />an on-line application, please visit our web site at www.leecountync.goy. <br />BOARDS AND COMMISSIONS <br />_ Sanford-Lee County Airport Authority - <br />Jury Commission <br />Agricultural Advisory Board _ <br />Library Board of Trustees <br />_ Americans with Disabilities Act (ADA) _ <br />Mid-Carolina Workforce Development Board <br />_ Board of Adjustments (Lee County) _ <br />Parks & Recreation Commission <br />Board of Adjustments (Sanford) - <br />Planning Board (Lee County) <br />Board of Equalization & Review - <br />Planning Board (Sanford) <br />_ Cemetery Board of Trustees _ <br />Rest Home-Nursing Home Advisory Board <br />CCCC Board of Trustees _ <br />Senior Services Advisory Board <br />_ <br />_ Lee County Economic Development Corporation _ <br />Social Services Board <br />_ Lee County Fire Advisory Board _ <br />Transportation Advisory Board <br />_ Lee County Environmental Affairs Board <br />~ <br />Juvenile Crime Prevention Council <br />_ <br />_ Lee County Board of Health <br />Criminal Justice Partnership Advisory Board <br />Industrial Facilities & Pollution Control Financing Auth. <br />• NAME: <br />ADDRESS: <br />HOME PHONE: -I Iq - q--) - I~ <br />PLACE OF EMPLOYMENT: C 1 C I) r7I <br />WORK PHONE: 119 ` /r) b - 2");? <br />I CERTIFY THAT ALL OF THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE TO THE <br />BEST OF MY KNOWLEDGE. ~~pA <br />DATE: 1301_p q_ <br />u S' ature of Applicant <br />NOTE: MUST BE A RESIDENT OF LEE COUNTY, AND CAN ONLY SERVE ON TWO (2) BOARDS AT A TIME. <br />Return completed application to: Ms. Gaynell Lee, Clerk to the Board of Commissioners, PO Box 1968, 106 <br />Hillcrest Drive, Sanford. North Carolina, 27331-1968, or fax to 774-8407 or e-mail to gleceleecountvnc.gov. <br />AN 3 0 200q <br />OCCUPATION fl pelM Itbr I b wAe&- J <br />1 <br />EMAIL: Lwimbrs@_ WI►'V1Sfi'C. FAX NO. l"I' 1 1 1~b 1SR <br />46 <br />List any experience/qualifications you have relevant to the above board/commission you are interested in. <br />