Form 14003 Researcher Application

Researcher Application

14003_F_B_08_05

Researcher Application

OMB: 3095-0016

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RESEARCHER APPLICATION

Applicant’s Name (Last, First, Middle Initial. Please indicate Mr. or Ms.)


Type of Application

New Renewal

Permanent Address (Street, City, State, Zip Code, Country)


Permanent Telephone No.


Permanent Fax No.


Email Address


Local Address (Street, City, State, Zip Code)


Local Telephone No.


Cell Phone


This information, although not required for obtaining an identification card, would aid our staff in assisting your research.

Type of Researcher

Genealogist Scholar/Academic

Journalist/Media Student

Other: ___________________________________

Description of proposed research (Identify topic specifically, e.g., date span, research area, full name of biographical subject, etc.)

Expected Result of Research

Family History Senior or Masters Thesis Article Film/TV

Course Paper PhD Dissertation Book Other (specify) ___________________

Tentative Title

Name of Instructor, Thesis or Dissertation Director/advisor

Occupation

Name and Address of Employer or Institution




Check here if you do want to be on a mailing list to receive information on NARA events, programs, publications, and invitations to join and contribute to NARA-associated foundations.


See the back of this form for the Privacy Act Notice that applies to the information you are providing.


I have read 36 CFR Part 1254 (Regulations for the public use of records in the National Archives and Records Administration) and I will comply with those regulations.

Applicant’s Signature

Date

FOR NARA USE ONLY

Identification (example: driver’s license, student ID, passport, company ID, etc.)

COMMENTS

Signature and title of approving official

Date

Card No.

NATIONAL ARCHIVES AND RECORDS ADMINISTRATION NA 14003 FRONT (8-05)



RESEARCH ROOM RULES (for complete research room rules, see 36 CFR Part 1254).


Researchers may not bring into most research rooms, overcoats, raincoats, hats, or similar apparel; brief cases, suitcases, daypacks, purses, or similar containers for personal property; notebooks, notepapers, note cards, folders and other containers for papers not essential to the researcher’s work requirements. These personal items should be stored in lockers or other storage facilities conveniently located outside research rooms and must be removed each night.


Personal computers, tape recorders, hand-held cameras, other audio-visual equipment, and typewriters may be brought into the research room only after inspection and only if their use will not disturb other researchers. Scanners must meet NARA requirements and can only be used where permitted and in designated areas. Drum and automatic feeder scanners are prohibited. Hand-held wallets and coin purses for carrying currency, coins, credit cards, keys, drivers’ licenses and other identification cards may be brought into the research rooms. Notes, references, lists of records to be consulted, and other materials may be admitted if they are essential to the researcher’s work. All equipment, personal possessions, and documentary materials are subject to inspection when the researcher enters or leaves the research room.


Researchers must exercise all possible care to prevent damage to the records. Records must not be leaned on, written on, folded anew, traced, or handled in any way likely to cause damage. Only one box or one folder of loose paper may be opened at any time. Eating, smoking, drinking, loud talking or other activities likely to disturb other researchers are prohibited in research rooms.


Failure to abide by these rules may result in the revocation of the researcher identification card.



In compliance with the Privacy Act of 1974, the following information is provided:


Solicitation of the information is authorized by 44 U.S.C. 2104. Disclosure of the information is voluntary; however, the effect of not providing the information is that a researcher identification card will not be issued to the individual. A researcher identification card is required for research using other than microfilm records.


The information provided will be used to identify and record individuals who use records in the National Archives, regional records services facilities, and Presidential libraries, to determine records that the individual should use, to enable later contact with the individual if additional information is found or if problems with the records are discovered, and to mail notices of events and programs of interest to users of the records and invitations to participate in customer satisfaction surveys.


The information may be transferred to appropriate Federal, State, local, or foreign agencies when relevant to civil, criminal, or regulatory investigations or prosecutions; the information may be disclosed by NARA to an expert, consultant, or a contractor of NARA to the extent necessary for them to assist NARA in the performance of its duties; the information may be disclosed to the U.S. Department of Justice or to a court or adjudicative body in cases involving the mutilation or unlawful removal of the records.



PAPERWORK REDUCTION ACT PUBLIC BURDEN STATEMENT

The information requested on this form is being collected and used by NARA in order to screen individuals, to identify which types of records they should use, and to allow further contact. You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Public burden reporting for this collection of information is estimated to be 8 minutes per response. Send comments regarding the burden estimate or any other aspect of the collection if information, including suggestions for reducing this burden, to National Archives and Records Administration (NHP), 8601 Adelphi Road, College Park, MD 20740-6001. DO NOT SEND COMPLETED FORMS TO THIS ADDRESS.

NATIONAL ARCHIVES AND RECORDS ADMINISTRATION NA 14003 BACK (8-05)

File Typeapplication/msword
File TitleRESEARCH APPLICATION
AuthorNancy Allard
Last Modified ByTamee E. Fechhelm
File Modified2008-08-22
File Created2008-08-22

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