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TALENT BANK INFORMATION QUESTIONNAIRE To be completed by persons desiring to volunteer their services on Authority, Board or Commission for Augusta-Richmond County. NOTE: Any information entered on this questionnaire would become public information upon your appointment. 1. Home Bus 2. Street County State Zip 3. Date of Sex: Female_________ 4. Registered Voter: 5. Voting 6. Martial Status:Single__________ Married__________ Separated__________ Engaged________ Divorced_________ 7. Education: High 8. Relatives working for the City or County: 9. _ 10. Race: African-American_________ Asian American___________ Spanish Surnamed____________ American Indian________ 11. List Boards you presently serve on: ---PAGE BREAK--- 12. List any area in which you have a particular interest or expertise. ---PAGE BREAK--- PUBLIC NOTICE If you are a resident of Augusta-Richmond County and interested in serving on the following Augusta-Richmond County Authorities, Boards and Commissions, please submit your Talent Bank application to the Clerk of Commissions Office Room 806 Municipal Building, 530 Greene Street, Augusta, Georgia 30911. Applications may be obtained from the Clerk's Office or The Augusta-Richmond Library, Main Branch, 902 Greene Street. 12. Advisory Board for the Disadvantaged 13. ARC Animal Control/Dangerous Dog Control Board 14. Aviation Commission - Bush Field 15. Aviation Commission - Daniel Field 16. Augusta Housing Authority 17. ARC Board of Zoning Appeals 18. ARC Housing Rehabilitation Board 19. ARC Historic Preservation Board 20. ARC Human Relations Commission 21. ARC Personnel Board 22. ARC Planning Commission 23. ARC Riverfront Development Review Board 24. ARC Tree Commission 25. Augusta Ports Authority 26. Board of Trustee of ARC Public Library 27. County Board of Family and Children Services 28. Downtown Development Authority 29. House Bill 100 Regional Metal Health, Mental Retardation and Substance Abuse Board 30. Industrial Development Authority 31. Richmond County Sheriff=s Merit System Board 32. ARC Community Development Citizens Advisory Committee 33. Augusta Housing Rehabilitation Board (Residential Care Facilities for the Elderly Authority) 34. ARC Construction Board Lena J. Bonner Clerk of Commission