Form 6045 Volunteer Service Application

OMB control no. 3095-0060 • expires 01/31/2013

VOLUNTEER SERVICE APPLICATION
Instruction Sheet
Thank you for your interest in becoming a volunteer at the
Our volunteers play a vital role in the activities at the
They supplement the staff in important ways with special talents and knowledge
that might not be otherwise available.
Please note that you must meet the following requirements in order to be qualified as a NARA volunteer: you must be 16 years or older and meet one of the following three requirements: (1) you must be a U.S. citizen; (2) you must be a legal
resident alien [possessor of a green card]; or (3) you must be a holder of a type A1
or A2 diplomatic visa. If you do not meet these requirements, we will not be able to
accept your volunteer application.
The next step in applying to become a volunteer is to complete the attached
form. Your answers to the questions will enable us to see where you might best help
our program and what activities would be most fulfilling to you. Many of the questions are self-explanatory. Others might need a little explanation.
Please note that a background check will be necessary, depending on the type
of volunteer service you will provide and the kind of access you are granted to our
facility. For further information about this step in the application process, please
contact the volunteer coordinator at
Please read the Paperwork Reduction Act Burden Statement and the Privacy Act
Statement that follow. The Privacy Act Statement explains the circumstances under
which this information may be shared with someone other than NARA staff. Be
assured that any information you provide will be held in the strictest confidence
and divulged to others only in compliance with the Privacy Act and the Freedom of
Information Act.
PAPERWORK REDUCTION ACT PUBLIC BURDEN STATEMENT
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 25 minutes
per response. Send comments regarding the burden estimate or any other aspect of the collection of information, including suggestions for reducing this burden, to National Archives and Records Administration (I), 8601 Adelphi Road, College Park, Maryland 20740. DO NOT SEND COMPLETED VOLUNTEER APPLICATION FORMS TO THIS ADDRESS. SEND COMPLETED
FORMS TO THE ADDRESS INDICATED ON THE BOTTOM OF THIS FORM.
PRIVACY ACT STATEMENT
Collection of this information is authorized by 44 U.S.C. 2104 and 44 U.S.C. 2105(d). The information you provide to NARA on
this form will be used to determine if you will be accepted as a volunteer. This information may be disclosed to an expert, consultant, agent or contractor of NARA to the extent necessary for them to assist NARA in the performance of its duties or in accordance
with any other “routine uses of records” listing in the Privacy Act System of Records NARA 26, “Volunteer Files.” Completing this
form is voluntary, but failure to provide all of the requested information will result in you not being accepted as a volunteer.

SEND YOUR COMPLETED APPLICATION:
BY FAX:
Mail

BY E-MAIL

National archives and records administration • na form 6045 (11-12)

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OMB control no. 3095-0060 • expires 01/31/2013

VOLUNTEER SERVICE APPLICATION

PERSONAL INFORMATION Please provide a phone number at which we may reach you
Monday through Friday, during business hours to follow up on your application. You also
may provide an email address for that purpose.
Please check if you have
Name

Mr.

Mrs.

U.S. Citizenship

a green card

an A1 or A2 diplomatic visa

Ms.

Date of birth (MM/DD/YY)
Street address, city, state, zip

Telephone number

Email

EDUCAT ION
Level

Name / Location of Institution

Years Attended

High school

Diploma/GED
Yes

College

Years Attended

No

Field of Study

Undergraduate

Undergraduate

Graduate

WORK EX PE RI E NCE
(Summarize your last 10 years of employment) When listing your work experience, show only the last
10 years of employment. If you are retired, describe the last 10 years you worked before you retired.
Position

From / to

Employer

PREVIOUS VOLUNT E ER EX PERIENC E
Duties

From / to

Organization

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OMB control no. 3095-0060 • expires 01/31/2013

VOLUNTEER SERVICE APPLICATION FORM
LANGUAGES. An ability to speak and understand a foreign language most likely will be
used to greet and possibly guide foreign visitors. You would not be expected to explain highly
technical aspects of the
program. Reading and translating duties might
involve assisting the staff in reading and responding to foreign language correspondence or in
translating documents from the holdings of the
Foreign language(s) please list

Speak and Understand
Fluent / Proficient

Can read and translate into and from
Easily / Passably

Special languages:
American Sign Language

Highly skilled

Some ability

Braille

Highly skilled

Some ability

SPECIAL SKILLS. Check all that apply
The information you provide will help us to identify which activities at the
will most interest you and where you can make
the greatest contribution to our program.
Are you skilled in

Genealogical research using computers
Genealogical research using sources
other than computers please specify:

Do you have any other skills or
particular interests realted to
volunteering? Please list them:

Archival work such as holdings
maintenance, processing, or description
Data entry
Word processing
Excel
PowerPoint

WHE N A RE YOU AVA I L A BL E
Days:

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Hours:

REFERENCES. List two people who are not relatives who know about your ability
and knowledge. It is important that you provide the names of two individuals who can
be contracted to discuss your qualifications for a volunteer position. They will be informed
of the reason for the contact.
Name
Street address

Name
Street address

City, state, zip

City, state, zip

Telephone

Telephone

Signature

Date

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