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Rx Udte/IJme JHN-JU-eUU`(FRI) IJ~dr 91977(U758 P UUI <br />01/30/2009 15:21 FAX 9197770758 ERA AM110NS REALTY 16001 <br />G 3 <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.leecountyne.gov. <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 />T ransportation 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: -IIq - 1r) 5- I6Eib WORK PHONE: t11- / )D'0 22 <br />PLACE OF EMPLOYMENT: EC <br />OCCUPATION: iI~IM~tuY b WYIe*- <br />EMAIL: CC111)IYl ~Yt.S Wl V10IStYCAY1t FAX NO. "L "I' 1 l I b 1 iD <br />List any experience/qualifications you have relevant to the above board/commission you are interested in. <br />er; a Rea h k- Z fee l Z avn to ObAe o),...5 Aj <br />rPn iy a T)tmeev f OJJ h t n? l9A1%4-.5kYU• <br />I CERTIFY THAT ALL OF THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE TO THE <br />BEST OF MY KNOWLEDGE. n p [A~,vy1 <br />DATE: 1 0 b 9~ I / L <br />S" azure of Applicant <br />t <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 g1ga -tleecountync.aov. <br />.IAN 3 0 2009 <br />