Form 3-2323 Regional Advisory Council Reference/Key Contact Intervie

OMB Control No. 1018-0120
Expires XX/XX/XXXX

REGIONAL ADVISORY COUNCIL REFERENCE/KEY CONTACT INTERVIEW

Applicant: _______________________________________________
Panelist:

_______________________________________________

Date:

_______________________________________________

Before beginning the interview with the key contact or reference, let them know that there are five
questions and that the interview may take 15 minutes or less. If the contact or reference does not know
the applicant or does not want to participate, thank them for their time and close the interview.

____Reference

____ Key Contact

(Please check whichever applies.)

Name ____________________________________________________
Organization ______________________________________________
Title _____________________________________________________
Number of years in region______________
1. Please describe the applicant’s knowledge of your region’s fish and wildlife resources.

2. Please describe the applicant’s knowledge of your region’s customary and traditional subsistence
practices.

3. Please describe the applicant’s knowledge of commercial, sport, and other activities in your
region.

Page 1 of 2
(Supersedes Key Contact Interview portion of Form 7-FW 6)

FWS Form 3-2323
11/05

OMB Control No. 1018-0120
Expires 03/31/09

4. Please describe how well the applicant communicates with:
a. individuals, small and large groups

b. State, Federal, and tribal agency staff

c. people in their community

d. people in the region

5. Please describe the applicant’s leadership ability and his/her ability and experience with local,
regional, and Statewide organizations.

In accordance with the Privacy Act (5 U.S.C. 552a) and the Paperwork Reduction Act (44 U.S.C. 3501), please
note the following information. This information collection is authorized by the Alaska National Interest Lands
Conservation Act and regulations promulgated there under. It is our policy not to use your name for any other
purpose. The Federal Subsistence Board will use information that you provide to make recommendations to the
Secretaries of the Interior and Agriculture for appointment of members to the Federal Subsistence Regional
Advisory Councils. We will maintain this information in accordance with the Privacy Act, but may release it under a
Freedom of Information Act request (5 U.S.C. 552). OMB has assigned OMB Control No. 1018-0120, which
expires XX/XX/XXXX. Your response is voluntary. Response is not required unless a currently valid OMB control
number is displayed. The relevant burden for completing this form is 15 minutes. This burden estimate includes
time for reviewing instructions and the interview. You may direct comments regarding the burden estimate or any
other aspect of the form to the Service Information Collection Clearance Officer, Fish and Wildlife Service, Mail
Stop 222, Arlington Square, U.S. Department of the Interior, 1849 C Street, NW., Washington D.C. 20240.
Page 2 of 2
(Supersedes Key Contact Interview portion of Form 7-FW 6)

FWS Form 3-2323
11/05