Volunteer Programs

Instructions For [AD-2024]
SPONSORED ORGANIZA TION VOLUNTEER PROGRAM
SERVICE AGREEMENT
Section 1526 of the Food and Agriculture Action of 1981 [7 U.S.c. 2272] pennits the
Secretary of Agriculture to establish a program to use volunteers to perform a wide range
of activities to carry out the programs of or supported by of the Department of
Agriculture. 5 U.S.c. 3111 [as effected by Part 308 of Title 5, Code of Federal
Regulations] grants agencies the authority to establish programs designed to provide
educationally related work assignments for students in non-pay status.
The Volunteer Programs require volunteers to read. sign and date a "Program Service
Agreement" explaining the conditions or limitation of acceptance of assignments. The
"Service Agreement" will serve as the volunteer's official record of appointment of
service. The "Attendance Record" will serve as the volunteer's official attendance
documentation.
The sponsoring organization and the volunteer(s) reviews this f01111and signs and dates it
and provides some basic demographic infonnation to document that he/she understands
the program's conditions of service. Each volunteer wi 11sign and date this form. This
fonn will be used to document acceptance of the conditions of program and work
assignments as required by aPM and the Agency.
Indicate
original
servicing
original

how and where to send the completed form here. Example: Submit the
of the completed form in hard copy or facsimile to the appropriate USDA
office. To submit this form by facsimile you must have submitted an
signature on FSA-237, Facsimile Signature Authorization and Certification.

If electronic signature is authorized for the form include the following standard text also. If the
form is not authorized for electronic signature delete both paragraphs ..

Customers who have established electronic access credentials with USDA may
electronically transmit this form to the USDA serYicing office, provided that (1) the
customer submitting the form is the only person required to sign the transaction, or
(2) the customer has an approved Power of Attorney (Form FSA-211) on file with
USDA to sign for other customers for the program and type of transaction
represented by this form.
Features for transmitting the form electronically are available to those customers with
access credentials only. If you would like to establish online access credentials with
USDA, follow the instmctions provided at the USDA eP0l111Sweb site.

Page 1 of3

Items 1-5; 7-12 are to be completed by tile Sponsoring Organization
Fld Namel.1
Item No.

"'~ J'"

'.

'''.

~

Instruction

1
Name of
Organization

I Enter

2
Address

I

Enter organization address

3
Telephone
No.

I

Enter organization telephone number

4
Dutv Station

I Enter address of work location

5 Agency
7-11

I

organization name

Enter the employing Agency

Agreement

Read the agreement which sets the conditions for the acceptance of
volunteers by sponsored by organizations

12

The following is standard language for signature fields.

Liaison's
Name

If you are mailing or faxing this form, Plint the f01111and manually
enter your signature and/or that of your parent/guardian. If this form is
approved for electronic transmission and you have established
credentials with USDA to submit f0l111Selectronically, use the buttons
provided on the fonn for transmitting the f01111to the USDA servicing
office.

Signature
and Date

Items 6; 14 for FF AS use only.
Items 17(1-5) are to be completed by tile volu/lteers sponsored by organization
Fld Name / 1
Item No.

."

.

L7(1)

Name of
Volunteer

I Enter

17(2)
Address

I

volunteer's name

Enter volunteer's address

17(3)
I Enter volunteer's date of birth
Date of Bi11h

Page20f3

Instruction

17(4)

Social
Telephone

social security
number
Enter telephone
number

No.
Security
No.
17(5)

Item 17 (6-8) for FFAS use only

Page 3 of3