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HomeMy WebLinkAboutAgenda - 06-17-2003-9d3ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: June 17, 2003 Action Agenda Item No. 9-d- ~ SUBJECT: Personnel Hearing Board DEPARTMENT: Board of Commissioners PUBLIC HEARING: (Y/N) No ATTACHMENT(S): Under Separate Cover Membership Roster Letter of Recommendation Application/Resume of Person Being Recommended Interest List Applications/Resumes of Persons on the Interest List INFORMATION CONTACT: Clerk's Office, ext. 2130, 2125, 2126, 2129 TELEPHONE NUMBERS: Hillsborough Chapel Hill Durham Mebane 245-2130 968-4501 688-7331 336-227-2031 PURPOSE: To consider the appointment of one member to the Personnel Hearing Board. BACKGROUND: All members of the three-member Personnel Hearing Board are appointed by the Board of Commissioners with one member having experience in management and/or personnel administration. The term for this Board is for two years. The Personnel Hearing Board is charged with hearing employee grievances involving demotions, suspensions, and dismissals. It forwards its recommendations to the County Manager. It meets only as needed. There will be one vacancy at the end of June with the rotation off the Board of Ms. Barbara Delon. Ms. Susan L. Lyons has been recommended to replace her. The term would be a full two- yearterm and would expire on June 30, 2005. FINANCIAL IMPACT: None. RECOMMENDATION(S): Consider making one appointment to the Personnel Hearing Board as the BOCC may decide. 0 0 .--. N o o S ' o 0 0 O O O ~ ~ O 1 N N N O O ~ '. N N N 00 0o O •--~ '. C ~~ a~ ~p ~p 0 0 0 Vi ~p ~p o 0 0 ' M `D ~o ~ o 0 0 O ~ Q 0. W ~ Q C1. k O W ¢ ~ k O w ti .N w Q .D ~ ~ Q ' y C]. ~ p N ~ U U _ ',. U h ~ fV •~ N C O t , ~ F. ~ ~ O N ~ N ~ ... x ,-. 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N M OVA a ORANGE COUNTY 2 X02 NORTH CAROLINA CELEBRATING 250 YEARS Orange County Personnel Department 208 South Cameron Street Elaine Holmes Tel (919) 245-2550 Post Office Box 8181 Director Fax (919) 644-3009 Hillsborough, NC 27278 www.co.orange.nc.us June 2, 2003 MEMORANDUM TO: Margaret Brown, Chair Orange County Board of Commissioners FROM: Elaine Holmes, Personnel Director SUBJECT: Personnel Hearing Board Appointment The Personnel Hearing Board has three members. These presently are Barbara Delon (African American, female), Kay Hovious, (white, female) and Edwin Caldwell (African American, male). Each member presently resides in Chapel Hill. Ms. Delon has served three two-year terms as a member of the Personnel Board. In accordance with the Board of Commissioners' policies governing appointments, Ms. Delon's appointment will expire June 30, 2003 and she is not eligible for reappointment. From October 2001 through May 2002, five citizens have applied to serve on the Personnel Hearing Board. Orange County Personnel staff have reviewed the applications received and contacted or attempted to contact each of the five applicants to discuss their qualifications, interest and availability. Of the five applicants, one (Blair Sweeney) is planning to move out of the area and one (Charles Lee) has not responded to telephone messages and an e-mail to him was returned as undeliverable. The remaining three applicants (Robert Bailey, Susan Lyons, Glenn Wilson) indicate that they are available and willing to serve. All are white. Two live in Chapel Hill and one (Robert Bailey) lives in Eno Township. Each member of the Personnel Board must be a resident of Orange County and no County employee or officer is eligible to serve. In addition, one member of the Personnel Board must have had experience in public or private sector management or personnel administration. Mr. Edwin Caldwell, a current member of the Board, already satisfies this criterion. The Clerk's Office advises me that the Board of Commissioners wishes to have my recommendation as to whom to appoint to the Personnel Board. From among the applicants available at this time, I recommend the appointment of Susan Lyons. She has: • 25 years management, customer service, and quality training experience. • A background in human resources. • Current consulting business focusing on developing training curricula including supervisory training, employee relations and leadership and job skills development. Please let me know if I can provide any additional information. An Equal Opportunity/Affirmative Ac-ien Ee,nl....e. This space for office use only 2/4/2001 Page 1 of 2 Susan Lyons VOLUNTEER APPLICATION ORANGE COUNTY BOARDS AND COMMISSIONS If you are an Orange County resident, at least 18 years old, and willing to volunteer your time and expertise to your community, please complete this application and return to: Orange County Commissioners' Office P.O. Box 8181 Hillsborough, NC 27278 Phone (919) 245-2130; 688-7331; 227-3031 FX (919) 644-0246 NAME: --------------------------------- Susan L L ons HOME ADDRESS: ------------------ . y 400 Laurel Hill Road CITY: ----------------------------------- Chapel Hill STATE: -------------------------------- NC ZIP CODE: ---------------------------- 27514 TELEPHONE: (Home) -------------- 932-6460 TELEPHONE: (Work) --------------- TELEPHONE: (FAX) ---------------- 932-6466 EMAIL: _________________________________ ldilyons@intrex.net PLACE OF EMPLOYMENT: ------ Self Employed as training and organizational development consultant JOB TITLE: --------------------------- TOWNSHIP OF RESIDENCE: ---- Chapel Hil] ZONE OF RESIDENCE: ------------ - SEX: ------------------------------------ Female ETHNIC BACKGROUND: --------- Caucasian DATE OF BIRTH: -------------------- 07/09/48 LIST, IN PREFERENCE, THE BOARDS/COMMISSIONS ON WHICH YOU WOULD BE WILLING TO SERVE: I am open to any of these -they are not in a major order of preference. 1: ----Personnel 2.---Human Services 3. ----Planning 4. ---Historic Preservation 5. ----Arts Commission 6.--- Commission for Women Please list work, volunteer and educational experience. WORK EXPERIENCE: 25 years designing and conducting management, customer service, quality training and consulting primarily in business and industry. I have been involved in most human resources functions and have extensive experience in needs assessment and data gathering as well as training and coaching. Have lead partnering meetings for large construction projects throughout the state. Also, provide leadership development workshops and coaching for managers and executives. Started my career in NC training criminal justice personnel in sex crime investigation, managing victims and family crisis intervention (25 years ago). I also lead the long range planning effort of the NC Dept. Of Justice for 2 years. In the past year, I have 5 2/4/2001 Pa e 1 of 2 Susan L ons been trying to cut back on travel, so am working at home designing training curriculae for companies in the South East. My degree is organizational development and adult learning, and hands on experience. VOLUNTEER EXPERIENCE: I have not had a great deal of time to volunteer until this point. My projects in the last few years have. been limited to a long-range planning project in my church and three years on the board of the Friends of the Gallery of Art and Desilm at NC. State University. However, as a part of my company's public offering of leadership training seminar, often at least one slot per session is given to a private non-profit organization. EDUCATIONAL EXPERIENCE BA University of California; MA UCLA-Organizational Behavior and Adult Learning By submitting electronic application, applicant agrees to Ethics Guidelines and agrees to attend three-hour orientation. This form was submitted online, on Sun Feb 4 10:49:48 2001 ~~ Applicant Interest Listing by Board Name and by Applicant Name Personnel Hearing Board Contact Person: Elaine Holmes, Director Contact Phone: 919-245-2552 Mr. Robert F. Bailey Day Phone: 919-383-1669 Sex: Male 6015 Deerwood Lane Evening Phone: 919-383-1669 Race: Caucasian Durham NC 27705 FAX: Township: Eno E-mail: Date Applied: 05/14/2002 Skills: Accountant Also Serves On: Skills: Church Officer Also Serves On: Mr. Charles Lee Day Phone: 919-762-2525 Sex: Male 112 Finley Forest Dr. Evening Phone: 919-969-8136 Race: Caucasian Chapel Hill NC 27517 FAX: Township: Chapel Hill E-mail: cml@nc.rr.com Date Applied: 04/17/2002 Skills: Customer Service Also Serves On: Ms. Susan L. Lyons Day Phone: 919-932-6460 Sex: Female 400 Laurel Hill Road Evening Phone: 919-932-6460 Race: Caucasian Chapel Hill NC 27514 FAX; 919-932-6466 Township: Chapel Hili E-mail: ldilyons@intrex.net Date Applied: 10/08/2001 Skills: Organizational Dev. Consultant Also Serves On: Arts Commission Skills: Training Consultant Mr. Blair Sweeney Day Phone: 919-593-3160 Sex: Male 516 Granville Towers East Evening Phone: 919-370-4557 Race: Caucasian Chapel Hill NC 27514 FAX: Township: Chapel Hill E-mail: bsweeney@email.unc.edu Date Applied: 04/28/2002 Skills: Assistant Apartment Manager Also Serves On: Skills: Student Also Serves On: Mr. Glenn Wilson Day Phone: 919-966-7664 Sex: Male 214 Glandon Dr. Evening Phone: 919-967-3535 Race: Caucasian Chapel Hill NC 27514 FAX: Township: Chapel Hill E-mail: glenn_wilson@unc.edu Date Applied: 03/26/2002 Skills: Associate Dean Also Serves On: Skills: Professor Also Serves On: Skills: UNC-CH School of Medicine Also Serves On: Friday, June 06, 2003 Page 1 of 1 w -- FpR OFFICE USE ONLY ~ /~/o Z ~a ~ ~ of ~, C1c~7Brf ~ f.~q i ~e VOLUNTEER APPLICATION . . ORANGE COUNTY ADVISORY BOARDS AND COMMISSIONS If you are an Orange Gounty resid®nt, at least 1$ years old, and willing to volunteer your time and expertise to your community, please complete this application and red--'-- - Orange County Commissioners' Office D ~ ~ ~ u U ~ 1 P.O. Box 8181 Hillsborough, Nc x~z7s MAY 142002 Phone (919) 245-2128; 245-2129; 245-2130; 732 Fax: (819) 644-0246 • Email: nmartin~co_oran _ __ •NAME: HOME ADDRESS: 6015 DEERWOOD LANE CITY: ~.. _... DLjRHAM . ~r J. ~ ORANGE COUNTY ) _._,,, dip Code: 2 7 7 PHONE: (Day) 919 ,3~3 7 6_ 6g (Evening/late) SA~~ (Fax) EMAIL: NONE PLACE OF EMPLOYMENT: JOB TITLE: IN ORDER TO ASSURE COUNTYWIDE REPRESENTATION PLEASE INDICATE YOUR TOWNSHIP OF RESIDENCE: D Bingham D Cheeks D Hillsborough ~ Ena ^ Chapel Hill ^ Little River D Cedar Grove IN ADDITION, PLEASE INDICATE IF YOU LIVE IN_ ONE OF THE FOLLOWING AREAS: ~ Jolnt Planning Area D Extraterritorial Area ^ Transition Area WE ASK YOUR HELP IN ASSURING DNERSI'IY OF MEMBERSHIP BY AGE, GENDER AND RACE, BY ANSWERING THE FOLLOWING QUESTIONS: X~Male O Female ETHNIC BACKGROUND: D African American Caucasian ^ Hispanic D Native American ~ Other DATE OF BIRTH: 6/23/30 PLEASE LIST (IN ORDER OF PREFERENCE) THE BOARDS/COMMISSIONS ON WHICH YOU WOULD BE WILLING TO SERVE. 1. ABC C`dNTRf1 Rfl ~BANf,F. R~~ nnT**~.*+~~ ~,~, pRR~ANx:T.T. An~rrennY gOA. WORK EXPERIENCE: 1'F.RTT&'TFT1 DTTT2r Tn nn ~b~~~ ~~~ PARTN R AND PRrNG1'PAr rA* FTRI-~R STNrr 1g7~ ASSOCIATE NEAL ~BRADSHFR nu TAYTnR cry*n~ igg~ VOLUNTEER EXPERIENCE: TREASURER ST PHILIPS EPISCOPAL CHURCH . ~ FOR OFFICE USE ONLY Sal ~~ O Z t"a q ~ 2. o~ ~ ~o,~,ea-~- ~;' ~t i ~e EDUCATION: __ nrTRUAM wTr_u fir'unnr ~ ~ RADiiATE TY NO H CAROLINA CHAPEL HILL OTHER COMMENTS: USINEES AND ]iNOWLEDABLE WITH A E ENT OF BUSINESS. SOME KNOWLEDGE OF REAL ESTATE AND TAX LAWS. How did you become aware of Orange County volunteer opportunities? (Please check all that apply): Q~Newspaper D County Web Page ^ Current Orange County Volunteer ^ Radio ^ T.V. ^ Other ETHICS GUIDELINES FOR COUNTY ApVISORY BOARDS AND COMMISSIONS I agree by my signature below that, if appointed, I pledge to comply with the following ethics guidelines for advisory boards and commissions as adopted by the Orange County Board of Commissioners. • Members of advisory boards and commissions shall not discuss, advocate, or vote on any matter in which they have a conflict or potential conflict of interest or an interest which reasonably might appear to be in conflict with the concept of fairness in dealing with public business. A conflict of interest or a potential conflict occurs if a member has a separath, private, or monetary interest, either direct or indirect, in any issue or transaction under consideration. Any member who violates this provision may be subject to removal from the board or commission. • If an advisory board ar commission member believes he/she has a conflict or potential conflict of interest on a particular issue, then that member should state this belief to the other mrrmbers of his/her respective advisory board or commission during the board or commission's public meeting. The member should state the nature of the conflict, detailing that he/she has a separate, private, or monetary interest, either dined or indin3ct, in the issue ar transaction under consideration. The member should then excuse himself/herselffrorn considering and voting on the matter. In cases where an advisory board or commission member declares a conflict ar potential conflict of interest, the member shall excuse himselflherself from the board table/voting area until ail discussion, consideration, and voting is completed on the matter in question. • Any advisory board or commission member having questions or needing assistance regarding the irrterpretatian of these ethics guidelines or other conflict of interest matters should contact the administrative staff for the respective board or commission. Staff will assist the member with questions and interpretations and may provide a recommendation on whether or not the advisory board or commission member should excuse himself/herselffrorn voting. The member may request that the staff respond in writing. Staff may contact the County Manager for any additional assistance. If appointed, I agree to attend athree-hour orientation which will give an overview of how Orange County Government operates and its relationship to other governmental units. Stgnature ot,w. ,s/. Date YOLOTSK3:APPLCTNj N:~_YOLAPPL.DOC i ., D FOR OFFICE USE ONLY ` ~~ ' 1 ~ oL ~ ~~tE~ I ol=d • Cha~rl;~.~~ ~ VOLUNTEER APPLICATION '~~ __.. .ORANGE COUNTY ADVISORY BOARDS AND COMMISSIONS If you are an Orang® County resident, at least 18 years olds and wiping t4 volunteer your time and expertise to your community, please complete this application and return to: Orange County Commissloner~' Otllce P.O. Bax 8181 Hlllsborough~ NC 27278 Phone (919) 245-21?„S; 2gg.2129; ?45-213p; 7S2,g181 Fax: (919) 644-0246 • Email: nmartin~co.arange.ncus HOME ADDRESS: ~ !. a' . F• n le Fo ~sf - ~P, clnr. ~ C ka pe I N~ I ~, w~ Zip code: ~5l ~ PHONE: (Day) 6 ~a ' a~o~J "~ . -.-~(Evening/late) ~69-836 (F~) EMAIL: GMI hc.rr.COlh PLACE OFEMPLOYMENT; -s ~ h~5' F-Y-~(pAVOrs' :u,c, JOB TITLE: c K.t~aw~'r Sir v,e~. ~9e:~i- !N ORDER TO ~-SSURE COUN7'YWID>;~ REPRESENTATION PLEASE INDICATE YOUR TOWNSHIP OF RESIDENCE: ^ Bingham D Cheeks D Hgisborough p Eno @t'Chapet Hill d Little Rhrer d Cedar Grore IN ADDITION,~PLEASE INDICATE IF YOU LIVE 1N ONE OF THE FOLLOIMNG AREAS; ^ Joint Planning Area ~ Extraterritorial Area ^ Transition Area WE ASK YOUR HELP IN ASSURING DNERSITY OF MEMBERSHIP BY AGE, GENDER AND RACE, BY ANSWERING THE FOLLOWING QUESTIONS: I~Male D Female .. ~ ETHNIC BACKGROl1ND: ~ Others AmericanDATE OF B~ Hlspanic~O ~ American- ~ - 17TH. • +? 73 PLEASE L15T (IN QRDER OF PREFERENCES THE BOARDS/COAgM15510NS ON WHICH YOU WOULD BE WILLIN~i TO SERVE. 1, 19BC ~pq_rd !~ 2, Po~..r5 0~ he.~ ~d y~Sar Boer 5r~_~3.~~-~Hl~tr9~ Ph°se~ rW ~1/7cA Bv~ . WORK EXPERIENCE: ,~s or~$ F+-deavor.S ~y,c. -;//s~oroti NG Cns{~j,~,f~rV~~~ ent Sc'. . ~DO~ ~MiGI'w f};r /,` ~1o~ri1~.'l/e PVC Res~rra~rbri S~)es A en f- Ma ~c~ aoa/-s ~ Or ~o ~ Lee I~awMnd NG Rece {?cn~f D{1Scc Mghq er TNne dGbO--I=Eb,aG~l ~` ~t/i11'q~p. Ign~r2rs- GerM uS P05~ ~ (e Y~in~q~E /JG Worn Sfi,~c1 ~4N /94-5"H9 /997 VOLUNTEER EXPERIENCE: ise->~ Rov-~ Pro •ect' Raw/~A NG q ,--~~~ a~ i`' Nick Re rra.s S~Cr Sehq-~ CAwi ai Nor / ,7'u I -- Nav I g9' ~ Robeson CvNn PN~Ir'c Deriders 4~i'ce ~~e~t~ N rune-,~}u /9 ~ a COUNTY ppVl pl R BOARD$ qND CpMMISSIONS • / W ~~~/Ol FOR OFFICE USE ONLY Pa Z Coles L~~ EDUCATION: jf R~r3G-'t~' GIh iVBt~ A'1. ~,5~e l` o f Pal'~i cR/ M9~rq ,~~fi~ I/ir ia~q ~~~ b, ~ W~A A~ U111 i~'P,iSr` R~} fn i4N1Gl'~'CAh f . l~ ~N~@S (~/~A9R>~iNG •'T..ao iear7 OTHER COMMENTS: CoMpN~er S Ki Its I agree by. my signature below that, if appointed, I pledge to comply with the following ethics guidelines for advisory boards and commissions as adopted by the Orange County Board of Commissioners. Members of advisory boards and commissions shall rat discuss, advocate, or vote on any matter in which, theyhave a conflict or potential corrflic~ of interest or an interest.which reasonably might appear to be in conflict with the concept of fairness in dealing with public business. A conflict of, interest or a potential conflict occurs if a~member has a separate, private, or monetary interest, either direct or indirect, in~ any issue or transaction under consideration. ~ Any member who violates this provision may be subject to removal from the board or commission. . Y° k: • if an.advisory board or commission member believes he/she has a conflict or potential conflict of interest on a par'dcular issu®, then that member should state this belief to the other members of his/her respective advisory board or commission during file board or commission's public meeting. The member should state the nature of the conflict; detailing that helshe~i'ias a separate, private, ~or monetary interest, either direct ar indirect, in the issue or transaction under consideration. The member should then excuse himself/herselfirom considering and voting on the matter. Incases where an advisory board or commission member declares a conflict or potential conflict of interest, the member shall excuse himself/hersetFfrorn the board tabiefvodng area until ail d'rscussfon, consideratign, and voting is completed on the matter in quesgon: Any advisory board or commission member having questbns or needing assistance regarding the interpretation of these ethics guidelines or other conflict of interest matters should contact the administrative staff for the respective board or commission. Staff will assist the member with . questions and interpretations and may provide a reco,rmendation on whether or~not the advisory board or convnissicn member should eaawse himselfThersetffrornvoting. The member may request that the staff respond in writing. ,Staff may contact the bounty Manager fdr any additional assistance. if appointed, I agree to attend athree-hour orientation which will give an overview of how Orange County Government operates wind its relationship bo other governmental units. Gam,/-- ~ ,~_ o y ~~. o~ Signature _~~ • Date How did y~ u becoms.aware of Prange County volunteer opportunities? (please check aU that apPIY)~ ~®"Newspaper O County Web page D Current Orange County Volunteer ~ Radio D 7.V. O Other . // This space for office use only 4/28/02 Page 1 of 2 Blair Sweeney VOLUNTEER APPLICATION ORANGE COUNTY BOARDS AND COMMISSIONS If you are an Orange County resident, at least 18 years old, and willing to volunteer your time and expertise to your community, please complete this application and return to: Orange County Commissioners' Office P.O. Box 8181 Hillsborough, NC 27278 Phone (919) 245-2125; 688-7331; 227-3031 FX (919) 644-0246 NAME: _________________________________ Blair Sweeney HOME ADDRESS: ------------------ 516 Granville Towers East CITY: ----------------------------------- rh~„Ai u;n STATE: -------------------------------- NC ZIP CODE: ---------------------------- 27514 TELEPHONE: (Home) -------------- 919-370-4557 TELEPHONE: (Work) --------------- 919-593-3160 TELEPHONE: (FAX) ---------------- EMAIL: _________________________________ bsweeney@email.unc.edu PLACE OF EMPLOYMENT: ------ Granville Towers JOB TITLE: --------------------------- Assistant Tower Manager TOWNSHIP OF RESIDENCE: ---- Chapel Hill ZONE OF RESIDENCE: ------------ Does not apply SEX: ------------------------------------ Male ETHNIC BACKGROUND: --------- Caucasian DATE OF BIRTH: -------------------- 01/25/1982 LIST, IN PREFERENCE, THE BOARDS/COMMISSIONS ON WHICH YOU WOULD BE WILLING TO SERVE: 1: ---------------------- personnel Advisory Board 2• ---------------------- Agricultural Preservation Board 3• ---------------------- Recreation and Parks Advisory Council Please list work, volunteer and educational experience. WORK EXPERIENCE: Granville Towers, Assistant Tower Manager; assist in supervising the resident assistants that are assigned to every floor in Granville Towers, a privately owned residence hall at the University of North Carolina. They are responsible for enforcing the rules and making their residents feel at home away from home. For more information, contact Melissa Hotchkiss at (919) 370-4512. Office of Institutional Research, Student Research Assistant; Student assistants are used to gather and present statistics that help in budgeting and other policy issues to the UNC administration. Computer skills are used throughout this job. For more information, contact Lynn Williford at (919) 962-1500. Delmas Parker for Congress Campaign, Campaign Director: As campaign director, I devised the electoral strategy that was communicated to the public through the use of television, radio, and periodical advertising. For more information, contact Mr. Delmas Parker at (336) 877-5213. /~ VOLUNTEER EXPERIENCE: University of North Carolina Student Congress (2001-2002). Rules and Judiciary Committee Chairman during 83rd and 84th Sessions. North Carolina Democratic Party. 4/28/02 Pa e 2 of 2 Blair Sweene EDUCATIONAL EXPERIENCE: University of North Carolina at Chapel Hill. BA Political Science expected May 2004. South Caldwell High School--Hudson, NC. :Diploma received May 2000. OTHER COMMENTS: How did you become aware of Orange County volunteer opportunities? List all that apply: County Web Site If other, how? By submitting electronic application, applicant agrees to Ethics Guidelines and agrees to attend three-hour orientation.This form was submitted online, on Sun Apr 28 22:22:25 2002 `~~3 ~ n~ :"• FOR OFFICE USE ONLY ' ~-- ~ 2 G t enn W ~ lson I~R ~2 6 ,~ f~ VOLUNTEER APPLICATION ~~- ORANGE COUNTY ADVISORY BOARDS AND COMMISSION - H you are an Orange County resident, at least 18 years old, and willing to volunteer your time and expertise to your community, please complete this application and return to: Orange County Board of Commissioners' Office P.O. Box 8181 Hillsborough, NC 27278 Phone (919) 245-2125; 245-2129; 245.2130; 732.8181 Fax: (/919) 644-0246 • Email: npaciga~co.orange.nc.us NAME: ~ ~e "h ~, ~ i ~ S~ y HOME ADDRESS: ~ `7 ~~~ ~ g(a-r7 ~ --Y'_ CITY: ~ Zip Code: °~ / Sr~ ~ .. _-- - PHONE: (DaY) ~'` ~/V (Evening/late) / ~53~ PLACE 19F EMPLOYMENT: [J /uG CST JOB TITLE: IN ORDER TO ASSURE COUNTYWIDE REPRESENTATION PLEASE I KATE YOUR TOWNSHIP OF RESIDENCE: O Bingham O. Cheeks O H8lsborough O Eno- Chapel Hill .O~ Ltttle~Ziver~ O Cedar Grove- ~ -- - ~ -- . IN ADDITION, PLEASE INDICATE IF YOU LIVE 1N ONE OF THE FOLLOWING AREAS: © Joint Planning Area O Extraterritorial Area O Transition Area WE ASK YOUR HELP IN ASSURING DIVERSITY OF~EMBERSHIP BY AGE, GENDER AND RACE, BY ANSWERING THE FOLLOWING QUESTIONS: Male O Female ETHNIC BACKGROUND: O African American ~aucasian O Hispan c O Native American O Other ATE OF BIRTH: ^ ~ y PLEASE LIST (IN ORDER OF PREFERENCE) THE BOARDSlCOMMISSIONS ON WHICH YOU WOULD 8E WILLING TO SERVE. _ _ N WO K EXPERIENCE: ~/l~c- ' ' VOLUNTEER EXPERIENCE: FOR OFFICE USE ONLY EDUCATION: ~ ~-~-U ETHICS GUIDELINES FOR COUNTY ADVISORY BOARDS AND COMMISSIONS I agree by my signature below that, if appointed, I pledge to comply with the following ethics guidelines for advisory boards and commissions as adopted by the Orange County Board of Commissioners. Members of advisory boards and commissions shall not discuss, advocate, or vote on any matter in which they have a conflict or potential conflict of interest or an interest which reasonably might appear to be in conflict with the concept of fairness in dealing with public business. A conflict of interest or a potential conflict occurs, if a member has a separate, private, or monetary interest, either direct or 'ini3irec`~; in anyrssue or• trarisa~`6n under c:Orfs~' aeon:---A~yrnembeTVi-ho'vioi~tes this-provision may ~ - - be subject to removal from the board or commission. If,an advisory board or commission member believes he/she has a conflict or potential conflict of interest on a particular issue, then that member should state this belief to the other members of his/her respective advisory board or commission during the board or commission's public meeting. The member should state the nature of the conflict, detailing that he/she has a separate, private, or monetary interest, either direct or Indirect, in the issue or transaction under consideration. The member should then excuse himself/herselffcom considering and voting on the matter. In cases where an advisory board or commission member declares a conflict or potential.conflict of interest, the - . - ___ . - __. member shall excuse himself/herselffcom the board table/voting area until all discussion, consi r i n~-is~coi~npleted.eR#he-rxtiatte~ia ue 4 ~~~ __ Any advisory board or commission member having questions ar needing assistance regarding the ~` ~~~ interpretation of these ethics guidelines or other conflict of interest matters should contact the administrative staff for the respective board or commission. Staff will assist the member with questions and interpretations and may provide a recommendation on whether or not the advisory board or commission member should excuse himself/herself from voting. The member may request that the staff respond in writing. Staff may contact the County Manager for any additional assistance. If appointed, I agree to attend athree-hour orientation which will give an overview of how Orange County Government operates and its relationship to other governmental units. ~ z d 1, Date vou)7[SK3:APPLC7N: H:\_.VOLAPPL.DOC How did you become aware of Orange County volunteer opportunities? (Please check all that apply): O Newspaper O County Web Page , O Current Oran County Volunteer O Radio O T.V. Other C'a~,~g/ ~iy~°a'`2-' ~~