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100 <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 viaw.leecounlvnc qov. <br />BOARDS AND COMMISSIONS <br />10 <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 />tments (Sanford) _ <br />Planning Board (Lee County <br />y <br />Board of Equalization & Review Plan (Sanford) `no v K~ ) <br />- Cemetery Board of Trustees _ <br />Rest Home-Nursing Home Advisory Board <br />- CCCC Board of Trustees _ <br />Senior Services Advisory Board <br />Lee County Economic Development Corporation _ <br />Social Services Board <br />ee County Fire Advisory Board _ <br />Transportation Advisory Board <br />✓Lee County Environmental Affairs Board <br />_ <br />Juvenile Crime Prevention Council <br />- Lee County Board of Health <br />Z <br />r'.... R8I &`'°E artnership Advisory Board <br />- Industrial Facilities & Pollution Control Financing Auth. <br />(t w VAC: ,c,r.,) <br />NAME: U~ -.4 , L/ I]m - <br />ADDRESS: ~j6 <br />HOME PHONE: <br />PLACE OF EMPLOYMENT: <br />WORK PHONE: <br />OCCUPATION: /t f l~E 'r/r r 02 /i y 'j <br />g1 p~ ~f <br />EMAIL: rpi~/:~7/,t~+/iy~!/(i✓.o~',asi'.~.Lh'rr~ FAX NO. 9/9-~- %ZZ/) <br />List any experience/qualifications you have relevant to the above board/commission you are interested in. <br />I CERTIFY THAT ALL OF THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE TO THE <br />BEST OF MY KNOWLEDGE. <br />DATE: cJ - Z - 240,° Z~_ <br />Signature of A licant <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@feecountync.gov. <br />JUN 1 - 2009 <br />