Laserfiche WebLink
Rx Date /Time NOV- 22- 2010(MON) 09:18 9197761118 P_OF <br />FROM :BUDS B ARBECUE FAX N0. :9197761118 Nov. 22 2018 11 :24AM P2 01 <br />COUNTY OF LEE <br />APPLICA71ON TO SERVE ON BOARDS11COMMISSIONS <br />If you are a Lee County citizen interested in serving as a member of one of the County's Advisory Boards, <br />please Complete the form below and ma il to Clerk to the Board, Lee County Government Center, PO Box 1968, <br />Sanford, NC, 27331 -1968 or fax to 718-463 1. YOU MUST BE A RESIDENT OF LEE COUNTY TO APPLY. <br />BOARDS AND COMMISSIONS <br />Jury Commission <br />Sanford -Lae County Airport Authority _ Library Board of Trustees <br />Agriculture Advisory 13oary Mid - Carolina Workforce Development 816rd <br />_ Amedcans with Disabilities Ad (ADA) — Pa0z & Recreation Commission <br />_ Board of Adjustments (Lee County) -- Planning Board (Lee County) <br />Board of Adjustments (Sanford) Planning Board (Sanford) <br />Board of Equalization & Review Rest Home - Nursing Home Advisory Board <br />Cemetery Board of Trustees — Senior Services Advisory Board <br />_ CCCC Board of Trustees Social Services Board <br />_ Economic Development Corp. Transportation Advisory Board <br />Fire Advisory ___ Board _ Juvenile Come Prevention Council <br />Environmental Affairs Board <br />Criminal Justice Partnership Advisory Board <br />Board of Health <br />_ Industrial Facilities a Pollution Control Financing Auth. <br />NAME: 3 f LC. _ <br />• MAILING ADDRESS: �p ' '" -'!- SA'�{'x� n 2733 <br />HOME PHONE: 91q- 726 -6 233_ WORK PHONE: 9-77b-I 2� EMAIL BruAdO(�EN �����Qr A � <br />YEARS LIVING IN <br />LEE COUNTY: � —_ DISTRICT YOU LIVE IN: <br />MALE- BLACK:— <br />FEMALE:_ WHITE HISPANIC: __ NATIVE AMERICAN __ ._. OTHER <br />�D ,� (Iniwrn3hW for the pun, o,m of assuMn a O s Sect" or V,a commuNry) <br />EMPLOYER: 1Z!y ?�JALi.L1�S -v r= - - -81 C H ,�)o c k R� ✓ —_ —__ <br />OCCUPATION: <br />OTHER MUNICIPAL OR COUNTY BOARDS /COMMITTEES ON WHICH YOU ARE SERVING: NOn/� <br />(Generally, the Boafd Of Comm1, OOON Ooslras to brodtlen perre,lpallon on s Ntls/COmmisslone for as much dhzen involvement <br />as pOSSlblo; Ihurofu�a per awb policy, aOpoNUeos can serve on no more iho hire (2) aoardalCommleslona sl a tlme. <br />PLEASE LIST THREE (3) LOCAL PERSONAL REFERENCES AND PHONE NUMBERS <br />1. <br />2. <br />3. <br />i— <br />SIGNATURE: _ w��!_-- -_____ DATE �7— / <br />• <br />NOV 2 2 2010 <br />