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G 3 5 <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 wriw.leecountvnc.gov. <br />BOARDS AND COMMISSIONS <br />_ Sanford-Lee County Airport Authority Jury Commission <br />-Agricultural Advisory Board Library Board of Trustees " <br />_ Americans with Disabilities Act (ADA) Mid-Carolina Workforce Development Board <br />_ Board of Adjustments (Lee County) Parks & Recreation CommissionL <br />oard ofAd'u menu fSa~ ford) _ Planning Board (Lee County) <br />e/ Board of Equalization & Review _ Planning Board (Sanford) <br />emetery Eoardo Trus[€8s _ Rest Home-Nursing Home Advisory Board <br />_ CCCC Board of Trustees _ Senior Services Advisory Board <br />_ Lee County Economic Development Corporation _ Social Services Board <br />_ Lee County Fire Advisory Board _ Transportation Advisory Board <br />_ Lee County Environmental Affairs Board _ Juvenile Crime Prevention Council <br />-Lee County Board of Health _ Criminal Justice Partnership Advisory Board <br />Industrial Facilities & Pollution Control Financing A(u~th. ~/1 <br />NAME: G-kccI~Q->= VVILl.~Er,I C\'t C- 1 r ~ <br />• ADDRESS: i719 >rL1 ~ 13 I)Ws-:1LA b~1 ~ V `.SAkff _,(w KIC 11 5 <br />HOME PHONE: t l1J - 6et WORK PHONE: I <br />PLACE OF EMPLOYMENT: ( RE f I I'` E D) <br />OCCUPATION: ED) <br />EMAIL: 500 Jlrt~O:CvM FAX NO. IvlA <br />List any experience/qualifications you have relevant to the above board/commission you are interested in <br />K -IV <br />PILE "I- TN U SC A SERVED &N Id ~ m Rye ~~~2us <br />AND VUl~S CFHLI 09A&` bi QI) tlii l~i1-n APP(A,V' L-) A c, <br />1 <br />I CERTIFY t~ THAT Lcl~ ALL OF F THE THE INFORMATION 2 CONTAINED INAINED D IN IN E / THI AP AP L Lo T i_IGf?rl~lcSl~r??)~ccJ.Y_ <br />IGATTION ION IS IS TRUE TO THE <br />BEST OF MY KNOWLEDGE. f R5?kS h~ 1(? G~ 1~~~~ ~l~Ik~, <br />DATE:~I23~ 0~rci~~ i1 <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 glee(o)leecountync.gov. <br />FEB 2 5 zop~ <br />i~ <br />