Application Process (Full application)

PAPERWORK BURDEN DISCLOSURE NOTICE

Public reporting burden for collecting, compiling, and completing the information requested is estimated to be 4 hours. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Paperwork Reduction Project (3067-0303), Federal Emergency Management Agency, 500 C Street, SW, Washington, D.C. 20472.

FEMA Community Preparedness Division

Citizen Corps Affiliate

Acceptance of Terms and Conditions

The Mission of Citizen Corps is to bring community and government leaders and organizations together to involve community members and organizations in all-hazards emergency preparedness, planning, mitigation, response, and recovery.

The Citizen Corps Affiliate is an accredited national entity that through the Affiliation supports the mission of Citizen Corps by offering communities resources for public education, outreach, and training; that represents volunteers interested in helping to make their community safer and better prepared; or offers volunteer service opportunities to support first responders, disaster relief activities, and community safety and preparedness efforts.

The undersigned organization hereby agrees to the following terms and conditions:

• To notify the FEMA Community Preparedness Division of any change to the organization’s non-profit status, including any changes to 501(c)(3) status or State non-profit certification (N.B. This provision does not apply to government entities).

• To notify the FEMA Community Preparedness Division if the organization is or becomes listed on any federal or state register of financial non-responsibility.

• To provide relevant information when requested by the FEMA Community Preparedness Division, outlining how the organization has furthered or will further the mission of Citizen Corps, and how the organization has worked or will work with Citizen Corps Councils at the national, tribal, state, and local levels.

• To notify the FEMA Community Preparedness Division of changes in key administrative personnel or points of contact, and provide current contact information (e.g., names, titles, e-mails, postal mailing addresses, telephone and facsimile numbers) in a timely manner.

• To practice non-discrimination in hiring and in the provision of services.

• To notify the FEMA Community Preparedness Division, if the organization is no longer able to further the mission of Citizen Corps and/or to coordinate with Citizen Corps on mission-related activities.

• That the Citizen Corps Affiliate Program does not create any right, benefit, or trust responsibility, substantive or procedural, enforceable at law or equity, by any party against the United States, its agencies, its officers, or any person.

• That the Affiliation does not constitute endorsement of any specific program or organization by the Department of Homeland Security, Federal Emergency Management Agency or the Federal government, nor will an Affiliate’s membership or employees be deemed agents or assigns of the Department of Homeland Security, Federal Emergency Management Agency, or the Federal government.

• That Affiliate status does not confer or encompass financial support of or obligations from Citizen Corps, the Department of Homeland Security, Federal Emergency Management Agency, or the Federal government to Affiliates.

The Affiliation will be reviewed every three years and may be amended at any time by mutual agreement of both parties. Either party may terminate the affiliation upon 90 days written notice, without written cause or recourse by either party.

Failure to comply with these terms and conditions may result in termination of affiliate status.

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Citizen Corps Affiliate Programs and Organizations

Affiliation Procedures

Citizen Corps Affiliate Programs and Organizations offer communities resources for public education, outreach, and training; represent volunteers interested in helping to make their community safer; or offer volunteer service opportunities to support first responders, disaster relief activities, and community safety efforts.

1. To be considered for official Affiliation with Citizen Corps, programs and organizations must:

• Support the mission of citizen participation in making America safer,

• Be non-profit or government sponsored and nationwide in scope,

• Be non-partisan, and

• Not be listed on any Federal or State registers of financial non-responsibility.

2. Interested programs and organizations are asked to provide a written request for Affiliation to the Citizen Corps Affiliate Review Panel; 800 K Street, Suite 640, Washington D.C. 20472-3630 and to include the following information:

• A signed Citizen Corps Affiliate Programs and Organizations Acceptance of Terms and Conditions form (attached);

• A copy of the organization's Constitution or charter, and bylaws, with evidence therein of their commitment to non-discrimination in hiring and in the provision of services (If such language does not exist in the constitution, charter, or bylaws, FEMA will require written assurances of non-discrimination in hiring and provision of services by a form attachment executed by an authorized signatory of the organization in lieu of such wording in the corporate charter, constitution or by-laws);

• A brief history of the organization, including its mission statement, membership, and examples of past practices;

• A copy of the Internal Revenue Service's certification of the organization's 50l(c)(3) status or a State non-profit certification (N.B. This provision does not apply to government entities);

• A statement as to how the organization plans to further the Citizen Corps mission;

• A statement as to how the organization will work with Citizen Corps Councils at the National, State, Tribal, or local levels;

• Names and titles of administrative personnel or points of contact; and

• Address and telecommunications information, including e-mail and web site addresses.

3. Upon review and approval of a request for Affiliation, Citizen Corps and the approved organization will sign a “Statement of Affiliation,” which will include an agreement to:

• Recognize the common purpose and mission between Citizen Corps and the approved organization;

• Publicly acknowledge the Affiliation, which may include website links, co-logos on publications, and references in printed materials;

• Coordinate activities to ensure efficient use of the organization’s resources for Citizen Corps; and

• Keep each other informed of activities conducted in support of Citizen Corps and provide an annual report summarizing those activities

• Re-evaluation of the Statement of Affiliation and partnership every 3 years by Citizen Corps and the approved organization.

Affiliation with Citizen Corps at the Federal level does not constitute endorsement of any specific program or organization by the Department of Homeland Security (DHS), Federal Emergency Management Agency (FEMA), or the Federal government, nor will an Affiliate’s membership or employees be deemed agents or assigns of DHS, FEMA or the Federal government. In addition, Affiliate status does not confer or encompass financial support of or obligations from Citizen Corps, FEMA, DHS, or the Federal government to affiliates programs or organizations.

FEMA Community Preparedness Division

Citizen Corps 501(c)(3)

Documentation Requirements

• A Citizen Corps Affiliate Acceptance of Terms and Conditions form signed by the principals of the applicant organization;

• A copy of the applicant organization's Constitution or Charter, and Bylaws, with evidence therein of their commitment to non-discrimination in hiring and in the provision of services;

• A brief history of the applicant’s organization, including its mission statement, membership, and examples of past practices;

• A copy of the Internal Revenue Service's certification of the applicant organization's 50l(c)(3) status or a state non-profit certification (N.B. This provision does not apply to government entities);

▪ A statement as to how the applicant organization plans to further the Citizen Corps mission;

• A statement as to how the applicant organization will work with Citizen Corps Councils at the national, tribal, state, or local levels;

▪ Names and titles of key administrative personnel or points of contact; with current contact information, (e.g. e-mail and postal mailing addresses, telephone, facsimile numbers) and applicant organization’s web site address.