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- 3 t <br />O <br />COUNTY OF LEE <br />BOARDS/COMMISSION APPLICATION <br />The Lee County Board of Commissioners believes that all citizens should have the opportunity to <br />participate in governmental decisions. One way of participating is by serving as a citizen member of one <br />of the county's advisory boards, listed below. If you have an interest in being considered for appointment <br />to one of the boards, indicate by placing a check mark by your interest(s), complete the form below, <br />and mail to the address listed at the bottom of the application. For additional information about our <br />committees or to complete an on-line application, please visit our web site at www. leecountync.gov. <br />BOARDS AND COMMISSIONS <br />_ Sanford-Lee County Airport Authority _ Jury Commission <br />_ Americans with Disabilities Act (ADA) _ Library Board of Trustees <br />Board of Adjustments (Lee County) Mid-Carolina Workforce Development Bd. <br />_ d of Adiustmantc lSanT (o_ r> Parks & Recreation Commission <br />Board of Equalization & Review ' Planning Board (Lee County) <br />_ andoned Cemetery Board of Trustees _ Planning Board (Sanford) <br />CCCC Board of Trustees _ Rest Home-Nursing Home Adv. Board <br />_ Lee County Economic Development Corporation Senior Services Advisory Board <br />_ Lee Countv Fire Advisorv Board Social Services Board <br />_ Lee County Environmental Affairs Board _ Transportation Advisory Board <br />_ Lee County Board of Health _ Juvenile Crime Prevention Council <br />Industrial Facilities & Pollution Control Financing _ Criminal Justice Partnership Advisory Bd. <br />® NAME: Jl0~4 r1(G14I) Nl,C DovJAI.D <br />ADDRESS Q"- 0q WE-ViLrW006 b21yc_, F~Ro L 133 <br />HOME PHONE.- Ct(~ ' 96 '6 / ~19 6W9'P1~PHON'F 3 W_ 6 <br />PLACE OF EMPLOYMENT: ICL" I IR E~ <br />OCCUPATION: <br />EMAIL-/YN,r _ •'Wlc~e,n ~+'~y~""~ r" ,C.(6'VAX NO. I I y ~O -tC /`f <br />List any experience/qualifications you have relevant to the above board/commission you are interested in. <br />30 1=/ 2$ OF INCiZ~ASrA) r SPOASf731CllyId S L[ S /VG9R5Ei~nJj <br />l~lST((IR?I(U 1 lJliirl IFi~xiAL fj IA 61'E~-j1~rRt~( MA-fJ,46',rM[,i l oxm') <br />PV)PM13FR of (iJ43~iC CoMMi5Sic9 A,N)L) OtAi2i-i-~4 aF SE,f€FAL P21JATL L-IAbj <br />I CERTIFY THAT ALL OF THE INFORMAT ION CONTAINED IN THIS APPLICATION IS TRUE TO THE <br />BEST OF MY KNOWLEDGE. <br />DATE ZUo.~ <br />Signtu`-~ <br />of Applicant <br />v <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 />oleeg eecountync-qov_ <br />FEB 2 4 2009 <br />