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5~'Yl-i sl/ ! Qvh~-! ~ ' ~s Ici_-~r.rrL - t~1~e,--nom <br />• COUNTY OF LEE <br />BOARDS/COMMISSION APPLICATION <br />0 5 <br />~ <br />I CERTIFY THAT ALL OF THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE TO THE <br />BEST OF MY KNOWLEDGE. <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 />0 <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 />CCCC Board of Trustees <br />Rest Home-Nursing Home Advisory Board <br />senior services Advisory Board( <br />il^ <br />c <br />_ Lee County Economic Development Corporation <br />_ Social Services Board <br />_ Lee County Fire Advisory Board <br />-Transportation Advisory Board <br />_ Lee County Environmental Affairs Board <br />-Juvenile Crime Prevention Council <br />_ Lee County Board of Health <br />_ Criminal Justice Partnership Advisory Board <br />_ Industrial Facilities & Pollution Control Financing A <br />uth. <br />NAME: _ ER. I. S <br />ADDRESS: 117 El -T-t 5 STR~k <br />l i 6319 f ecAF,>, C. 2733C? <br />HOME PHONE: q`11 776-229/ WORK PHONE: j <br />PLACE OF EMPLOYMENT: KET124 >021-V C' IVISIPA( 0,' ViNl-A /I~f}~ irA9 f 770'w) <br />OCCUPATION: !Yo/YI&z2zdki=A <br />EMAIL:. S1LFR7)7allmPrI~_ -Com FAX NO. 'DVS <br />List any experience/qualifications you have relevant to the above board/commission you are interested in, <br />DATE: d Pl X&-) <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 glee(cNeecountync.gov. <br />is <br />