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Educational Background: <br />Business and Civic Experience: <br />Areas of Interest / Skills: <br />Other County Boards / Committees / Commissions presently serving on: <br />Term Expiration Date: <br />Have you ever been charged with and / or convicted of a criminal offense? If so, please explain <br />References <br />List three persons who are not related to you and who have definite knowledge of your qualifications and fitness for the <br />position for which you are applying. <br />Name Business / Occupation Address Telephone <br />I understand that this application will be kept on active file for two years and I hereby authorize Cabarrus County to verify <br />all information included in this application. I further understand this application is subject to the N. C. Public Records <br />Law (NCGS 132 -1) and may be released upon request. Meetings of the appointed boards and committees are subject to <br />the N. C. Open Meetings Law (NCGS 143- 318.10). <br />Date <br />BOC 001 (Revised 07106) <br />Signature of the Applicant <br />Attachment number 4 <br />1 -6 Page 74 <br />