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NAHE OF ADVISORY BOAR~ (COMHITTEE/COHHISSION TO ~H~CH PERSON IS NOMINATED <br /> <br /> NURSING ttOME COMMUNITY ADVISORY COMMITTEE <br /> <br /> The ~bar~s ~unty Board of ~issioners sincere~y appreciates the interest of ~1 citizens <br /> tn ~ty ad~eo~ co~tttees ~d urges the public to nominate qualified persons for ~mberahi[ <br />'---ff~i~it~ns'~y be sent to: <br /> <br /> Cabae~s ~ty Board of ~ssione~s <br /> Po~t Office BOX 707 <br /> ~ncord, North Carolina 28025 <br /> <br /> ~or ~re ~fo~tion, applic~ts ~y review ~ the ~ty ~nager's Office the responsibilitie~ <br /> of various advisory bodies, <br /> <br /> ~R ~ ~S/~EES/~SSIONS ~S~Y SERVING ON:' <br /> TE~ ~I~T~ON DATE ~' <br /> <br /> NOMINEE BACKGRO~ I~O~TION: <br /> <br /> BUS.ESS ~D~SS ' ' ZIP CODE <br /> OC~PATION YHONE NO. <br /> <br /> NO. HO~S AVA~LE PER ~H FOR THIS POSITION <br /> EDUCATION ~ x~f~ ~ff~ <br /> <br /> A~AS OF E~ERTISE ~D I~E~ST/SKILLS ~.~. ~z~ ~ <br /> 0 / <br /> <br /> I understand that this application will be kept. ou the active file for <br /> two years only. <br /> <br /> Signature of:App licant <br /> <br /> <br />