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034' <br />E <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.gov <br />BOARDS AND COMMISSIONS <br />• <br />_ Sanford-Lee County Airport Authority <br />-Agricultural Advisory Board <br />-Americans with Disabilities Act (ADA) <br />Board of Adjustments (Lee County) <br />Industrial Facilities & Pollution Control Financing Auth. <br />,Board of Adjustments (Sanford) <br />_ Board of Equalization & Review <br />_ Cemetery Board of Trustees <br />_ CCCC Board of Trustees <br />_ Lee County Economic Development Corporation <br />_ Lee County Fine Advisory Board <br />_ Lee County Environmental Affairs Board <br />Lee County Board of Health <br />NAME: <br />ADDRESS: /O ~01 .S"Is'-it, -0c+ve- <br />HOME PHONE: WORK PHONE: <br />PLACE OF EMPLOYMENT: al~inwiw1, 1 ~2l~ct . (.)I4s <br />_ Jury Commission <br />_ Library Board of Trustees <br />Mid-Carolina Workforce Development Board <br />Parks & Recreation Commission <br />_ Planning Board (Lee County) <br />_ Planning Board (Sanford) <br />_ Rest Home-Nursing Home Advisory Board <br />_ Senior Services Advisory Board <br />_ Social Services Board <br />_ Transportation Advisory Board <br />_ Juvenile Crime Prevention Council <br />Criminal Justice Partnership Advisory Board <br />OCCUPATION: <br />tk ) 776 -q131 <br />EMAIL: r`1a1CoGfw~c~law.cor~ FAX NO (9I~t ) 77Y- S9Y3 <br />List any experience/qualifications you have relevant to the above board/commission you are interested in. <br />re..( e,s,I <br />";..g <br />Z vk~ My cry des <br />I CERTIFY THAT ALL OF THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE TO THE <br />BEST OF MY KNOWLEDGE. i f <br />DATE: 1 9 o g <br />Signature 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 gleeQ.Ieecountync.gov. <br />JAN 3 0 2009 - <br />