Laserfiche WebLink
038 <br />COUNTY OF LEE <br />APPLICATION TO SERVE ON THE REVOLVING LOAN COMMITTEE <br />If you are a Lee County citizen interested in serving as a member of one of the Revolving Loan Committee, 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 />Citizens applying for this Committee must be actively involved or have significant experience in one of the following <br />areas. Please check which area you will representing if appointed to the Committee: <br />Banking ✓ <br />Agriculture_ <br />Small Business <br />Note: Small Business is defined as any industry, manufacturing, commercial or retail business with less than 200 <br />employees and $20,000,000 annually in revenues. <br />NAME: —TC)f)DY.�z <br />MAILING ADDRESS: Znl,I'1 NarNe- S' -VD r 5"w-Foe'21 NL 2'133"L <br />HOME PHONE: �1t�1' y3S `(ZS2_ WORK PHONE: `1 ��1' `t�' 103E -MAILS <br />YEARS LIVING IN NIA- oil <br />LEE COUNTY: DISTRICT YOU LIVE IN: <br />MALE: _v,/FEMALE: —WHITE: ✓ BLACK: _ HISPANIC: _ NATIVE AMERICAN _ OTHER <br />(Information for the purpose of assuring a cross section of the community) <br />EMPLOYER: COVrr/IrL JAN - <br />OCCUPATION: 01ro\meleIA-t— /W4'2r_� (._0/ e <br />OTHER MUNICIPAL OR COUNTY BOARDS/COMMITTEES ON WHICH YOU ARE SERVING: <br />N'-W%kC_ <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 />Are you related to anyone currently serving on any County board/commission? If yes, please state name and board they serve on <br />PLEASE LIST THREE (3) LOCAL PERSONAL REFERENCES AND PHONE NUMBERS: <br />1. <br />2. <br />3. <br />REASON(S) YOU WISH TO SERVE AND EXPERIENCE IN THE AREA YOU WILL BE REPRESENTING ON THE <br />COMMITTEE: Wrar�r -rn BSc rt,� 2`1 YDS of Q��, c�p*¢�m�e -r l'r���dyP <br />To I.kt.,p -� Se2vc ' il� Ce/hm�tin-tc �, N ty 1-i 6A+ l,> 2�CJ <br />(Attach additional page if pace ded) <br />SIGNATURE: l" o (: t DATE: JZ 1131 I �o <br />NOTE: ALL TAXES MUST BE PAID IN FULL BEFORE BEING CONSIDERED FOR APPOINTMENT <br />THIS APPLICATION IS CONSIDERED A PUBLIC RECORD <br />