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00046 <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 $20,0000000 annually in revenues. <br />NAME: / /u h <br />MAILING ADDRESS: Ral SQ n "fal-,7336) <br />HOME PHONE: '717- 776-5R;-7 WORK PHONE: 7/Y 9 E-MAIL v <br />YEARS LIVING IN <br />LEE COUNTY: 3 DISTRICT YOU LIVE IN: f� <br />MALE FEMALE: _ WHITE:K BLACK: _ HISPANIC: _ NATIVE AMERICAN _ OTHER _ <br />(Information for the purpose of assuring a cross section of the commun' ) <br />EMPLOYER: Atg % S f h 7,' C %rte <br />OCCUPATION:anOr4 o,_, <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 />Are�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. 4 4 /�eS Jam— / 7t — <br />2. 0l✓ y - -7 7 5 -- -7 3 -/-/ <br />3. C � "). � — — 7 -2 <br />REASON(S) YO WIS TO SERVE AND EXPERIENCE IN THE ADIEA O WILL BE REPRESENTING PN THE <br />COMMITTEE: a <br />(Attach additional page if i ore a needed) <br />SIGNATURE: DATE: <br />NOTE: ALL TAXES MUST BEP ULL BEFORE BEING CONSIDERED FOR APPOINTMENT <br />THIS APPLICATION IS CONSIDERED A PUBLIC RECORD <br />