Form 6045 Volunteer Service Application for New York City

OMB Control No.: 3095-0060
Expiration date: 12/31/2012

VOLUNTEER SERVICE APPLICATION FORM
National Archives at New York City
INSTRUCTION SHEET
Thank you for your interest in becoming a volunteer at the National Archives at New York City. Our volunteers play a vital
role in the activities at the National Archives at New York City. They supplement the staff in important ways with special
talents and knowledge that might not be otherwise available.
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.
PERSONAL INFORMATION: Please provide a phone number at which we may reach you Monday through Friday, between
8:00 and 4:30 to follow up on your application. You also may provide an e-mail address for that purpose.
WORK EXPERIENCE: 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.
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 National Archives at New York City.
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 National Archives at New York City.
SPECIAL SKILLS: The information you provide will help us to identify which activities at the National Archives at New
York City office will most interest you and where you can make the greatest contribution to our program. Please mark those
activities on the list with which you have experience and indicate your level of expertise. Please add any other activities in
which you have experience that you think will fit into the National Archives at New York City’s program.
AVAILABILITY: Which days of the week and which hours on those days will you usually be available to volunteer your
services? On occasions, volunteers will be needed in the evening.
REFERENCES: It is important that you provide the names of two individuals who can be contacted to discuss your
qualifications for a volunteer position. They will be informed of the reason for the contact. Please note that a background
check will be necessary, depending on the type of volunteer service you will provide and the kind of access to our facility.
For further information about this step in the application process, please contact our volunteer coordinator at 212-401-1620.
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 (NHP), 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 LAST PAGE OF THIS FORM.
PRIVACY ACT STATEMENT
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. The information provided will be used to determine whether you will be accepted as a volunteer. Additionally,
the information may be provided to an expert, consultant, or contractor of NARA to assist NARA in the performance of its duties. If some or any of the
information is not provided by the applicant, the effect will be that you may not be accepted as a volunteer.

OMB Control No.: 3095-0060
Expiration date: 12/31/2012

VOLUNTEER SERVICE APPLICATION FORM
National Archives at New York City

PERSONAL INFORMATION
Name: Mr. Mrs. Ms

Date of Birth

Street Address

City

State

Daytime Telephone Number

ZIP

E-mail Address

EDUCATION
Level

Name and Location of Institution

High School

Years Attended

Diploma / GED
Please circle:

-Yes

College:

Name of Institution

Years Attended

Undergraduate

--

Undergraduate

--

Graduate

--

No

Major Field of Study

Degree

WORK EXPERIENCE
(Summarize your last 10 years of employment)
Position

From -- To

Employer

PREVIOUS VOLUNTEER EXPERIENCE
Duties

From -- To

Organization

NA 6045-NY (11-06)

LANGUAGES
Foreign Language(s) [Please list]

Speak and Understand
Fluently

Can Read and Translate into and from

Passably

Easily

Passably

Special Languages:
American Sign Language

No Ability

Some Ability

Highly Skilled

Braille

No Ability

Some Ability

Highly Skilled

SPECIAL SKILLS
(Check all that apply. H = Highly Skilled

S = Some Experience)

General

Computer

Skill Level:
Research: General
Genealogical
U.S. History:
Era of Interest:
Special Events: Planning / Staging
Librarianship
Archives
Teaching
Writing / Editing
Customer Service
Public Outreach
Other (Specify)

H

S

Skill Level:
Databases
Microsoft Word
Other Word Processing
HTML
Excel
PowerPoint
Other (Specify)

H

S

WHEN AVAILABLE
Days:

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Hours:
REFERENCES
Name

(List two people who are not relatives who know about your abilities and knowledge)
Name

Street Address

City

Street Address

State

City

State

ZIP

ZIP

Telephone

Telephone

Today’s Date

Signature

SEND YOUR COMPLETED APPLICATION:
By Postal Mail to:

By FAX to:

National Archives at New York City
201 Varick Street, 12th floor
New York, NY 10014-4811

212-401-1638

By e-mail to:
[email protected]

For questions about completing this form, please contact our Volunteer Coordinator at 212-401-1620.
NA 6045-NY Back (11-06)