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Application For Appointment To <br />Cabarrus County Advisory Boards and Commissions <br /> <br /> The Cabarrus County Board of Commissioners believes that all cidzens should have the opportunity to participate in <br />governmental decisions. One way of participating is by serving as a citizen member of one of the County's advisory boards. <br />If you want to be considered for appointment to an advisory board, please complete thc form below and mail it to the Board <br />of County Commissioners, Post Office Box 707, Concord, North Carolina 28026-0707. You may detach this page and use <br />as a self-mailer. <br /> <br />Advisory Board / Commission Interested In: <br /> <br />Cabarrus Health Authority Board <br /> <br />Resident of Cabarms County Lkl yes <br /> Circle your township <br />Central Cabarrus ~ <br />Concord _ .. ~ <br />Georgeville Midland <br /> <br />[] no <br /> <br />New Gileac <br />Odcll <br />Poplar Ten: <br /> <br />N.C. Driver's License No.: <br />Occupation: <br />Business Address[ ,~ <br />Age (optional): <br /> <br />Education~ Background: . <br /> <br />Gold Hill <br /> <br />Mount Pleasant Rimertown <br /> <br />Number hours available per month for this posmon: . <br /> <br />Other {2ounty Boards / Committees / Commissions presently serving on: Board, Committee, Commission: <br /> Term Expiration Date: /~ / / <br /> References <br />List three persons who are not related to you and who have definite knowledge of your quail fications and fitness for the positi <br />for which you are applying. <br /> <br />Name Business / Occupation Address Telephone <br /> <br /> "' z,,/ <br /> <br />I t~ndepstand that this application wilt be kept on the active file for two years only and I hereby authorize Cabarrus Count'., <br />verify 'all information included in this application. <br /> <br /> / Date Signature oE the Applicant <br /> <br />4-+ Cabarrus County Public Affairs Bulletin +'"' <br /> <br /> <br />