Laserfiche WebLink
V -iL <br />COUNTY OF LEE <br />APPLICATION TO SERVE ON BOARDS/ /COMMISSIONS <br />If you are a Lee County citizen interested in serving as a member of one of the County's Advisory Boards, please <br />complete the form below and mail to Clerk to the Board, (408 Summit Drive), PO Box 1968, Sanford, NC, 27331- <br />1968 or fax to 919- 718 -4623. YOU MUST BE A RESIDENT OF LEE COUNTY TO APPLY. <br />BOARDS AND COMMISSIONS <br />1 <br />2. <br />Sanford -Lee County Airport Authority <br />_ Agriculture Advisory Board <br />_ Americans with Disabilities Act (ADA) <br />_ Board of Adjustments (Lee County) <br />_ Board of Adjustments (Sanford) <br />_ Board of Equalization & Review <br />_ Cemetery Board of Trustees <br />_ CCCC Board of Trustees <br />_ Economic Development Corp. <br />_ Fire Advisory Board <br />Board of Health <br />_ Mental Health Board <br />YEARS LIVING IN <br />LEE COUNTY: I > STRICT YOU LIVE IN:/ 7 1 - <br />MALE: — FEMALE: _ WHITE: , _BLACK_ _ HISPANIC: _ NATIVE AMERICAN _ OTHER _ <br />1 <br />EMPLOYER: <br />_ Jury Commission <br />Library Board of Trustees <br />_ Parks & Recreation Commission <br />_ Planning Board (Lee County) <br />_ Planning Board (Sanford) <br />_ Senior Services Advisory Board <br />_ Social Services Board <br />Transportation Advisory Board (COLTS) <br />_ Juvenile Crime Prevention Council <br />_ Industrial Facilities & Pollution Control <br />Financing Authority <br />Rest Home - Nursing Home Advisory Board (cannot have <br />a relative residing in a facility) <br />NAME (�/f /Q L Y C fI y W-10 A , <br />M*ADDRESS d C*UU&f2 6M NX_ 2 72 <br />HOM PHONE: WORK PHONE: <br />OCCUPATION: <br />OTHER MUNICIPAL OR COUNTY BOARDS /COMMITTEES ON WHICH YOU ARE SERVING: <br />(Generally, the Board of Commissioners desires to broaden participation on Boards /Commissions for as much citizen involvement <br />as possible; therefore per Board policy, appointees can serve on no more than two (2) Boards /Commissions at a time. <br />PLEASE LIST THREE (3) LOCAL PERSONAL REFERENCES AND PHONE NUMBERS: <br />— 02 <br />•- T <br />3. ,411 b e E( <br />REASON(S) YOU <br />ago - -14 <br />SIGNA <br />NOTE: ALL <br />TO SERVE <br />rz / s - S a C f <br />- <br />TE: i �OKI <br />CO SIDERED FOR APPOINTMENT ;� <br />h <br />MUST BE PAID IN FULL BEFORE BEING <br />THIS APPLICATION IS CONSIDERED A PUBLIC RECORD OX 7—*" z- V c <br />JUG 1 5 2 wA "f / <br />p r <br />