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COUNTY OF LEE <br />APPLICATION TO SERVE ON BOARI <br />If you ane a Lee County citizen kenesied In serving as a member of one of the C <br />complete the form below and mail to Clerk to the Board, (406 Summit Drive), PO <br />1968 of tax to 919-7184M. YOU MUST QE A RESIDENT OF LEE COUNTY TO <br />_ SaMord-Lee Cc" Airport Authority <br />Agriculture Advisory Bood <br />_ Amerkans with Obabdibes Act (ADA) <br />Board of A4ustmenb (Lee Cow*/) <br />_ Board of AdJusbnenb (Sanford) <br />Board of Equali=%n & Review <br />_ Came" Board of Trustees <br />_ CCCC Board of T <br />Juvenile Crime Pm%vntbn Cowx:l <br />_ Flra Advisory Board <br />Board of Health <br />Menial Health Board <br />Dttlr+e S'habaZ <br />NAME: <br />MAILING <br />HOME PHONE: <br />Jury Commission <br />_ Library Board of Trustees <br />_ Peft & Recrostlon Commission <br />Panning Board (Lee County) <br />Planing Board (Sanford) <br />Senior Services Advisory Board <br />Social Services Board <br />_ Transporfstbn Advisory Board (G <br />industrial FacII10" & Pollution G <br />Financing Authority <br />!, Rest Home -Nursing Home Advlel <br />a rete residing In a facidty) <br />WORK PHONE <br />milord, NC 27330 <br />9.718-1259 E-MAIL <br />YEARS WING IN 3'r <br />LEE COMM. DISTRICT YOU LIVE INE <br />MALE.�L FEMALE: — WHITE: �cm _ HISPANIC: ,_,_ NATIVE AMER <br />for" Wspm of 41"W rp am" "ClIm of ft <br />EMPLOYER: The Sanford Herald <br />OCCUPATION: <br />OTHER MUNICIP. ALOR COUNTY a 0ARDS&MIMtT.T>=ES ON-MMCEI X00 AR <br />Chamber of Cot mei6 —Noord of Dis ectus beginning January <br />(evemlly, to same of Bc Ma ne Ae oto Monra0 <br />W POesIeMl, *dwdom Pa per• PA (2) <br />PLEASE LIST THREE,(3).LOCALP..ERSOAI/ILiREF,F1#ENCES AND PHONE <br />1. Tamara Brogan 919-352-2484 <br />2. <br />3. <br />Meg tdoss 919.775-7341 <br />►TYAiken 919-721.9626 <br />REASON(S) YOU WISH TO SERVE <br />I want to get more Invoked In my <br />(Aftdh sdalonal page It is -----d) 1i�8/2o1 <br />SIGNATURE: DATE: - _ <br />NOTE: ALL TAXES MUST BE PAID IN FULL BEFORE BEING CONSIDERED FOR <br />TMIS APPLICATION IS CONSIOEREO A PUBLIC <br />0?b <br />es Advisory Boards, please <br />1966, Sanfo, , NC, 27331 - <br />LY. <br />Board (cannot have <br />OTHER _, <br />C"Wh <br />a kIrm. <br />DEC - B2 <br />cj�\ J <br />