NMS Advisory Council - Youth Seat application

National Marine Sanctuary Advisory Council Youth Seat Application Form

Before applying for sanctuary advisory council membership, please review:

1. the sanctuary advisory council charter provided in your application kit, and;

2. the Office of National Marine Sanctuaries (ONMS) Sanctuary Advisory Council Implementation Handbook available online at http://www.sanctuaries.noaa.gov/management/ac/acref.html (or you may obtain a copy from your local sanctuary – see contact information below).

The charter outlines the purposes and governs the operation of the sanctuary advisory council. The handbook provides broader operational requirements for sanctuary advisory councils. In applying for sanctuary advisory council membership, you are agreeing to abide by the terms of the charter and the handbook if you are selected as a youth council member or alternate. Also, please note that youth seats are intended to engage high school students and, therefore, term limits for youth seats may be further limited once a youth reaches his or her 18^th birthday or graduates high school.

As a part of the selection process, please note that the Office of National Marine Sanctuaries will conduct a LEXIS/NEXIS check and a departmental bureau check for potential conflict of interest and other issues in your background.

Additional information and guidance regarding the use of the information you submit on this form and its availability under federal law can be found at the end of this form. Please review this information. Also, please note that the terms “youth” and “student” are interchangeable in this application form.

Students filling the youth seat must:

• Be between the ages of 14 and 17 when they apply;

• Attend a school, including home schools (or other alternative high school option), in the area affected by the sanctuary;

• Have a proven ability to communicate and network with other students within their school, in other schools within their community, or with home-schooled students and with adults;

• Possess an interest in sanctuary resource protection and management;

• Have experience or knowledge regarding public uses and activities in the sanctuary;

• Be able to travel to and attend council meetings and retreats (parent/guardian or student provides transportation); and

• Provide written recommendations from one or more teachers.

Once selected, [insert site] National Marine Sanctuary staff will contact students who will be required to provide:

• Parent/guardian permission;* and

• School permission.*

* Note: This will grant blanket permission for all council meetings and retreats.

Procedure for Application:

Step 1: Please provide your contact information and respond to the questions below.

Step 2: Have a parent/guardian sign to acknowledge he/she is aware of and in support of your application.

Step 3: The application deadline is [insert date]. Please return all pages of your completed sanctuary advisory council youth seat application form, and any attached statements or documents, to [insert local contact information].

Date: __________________

First Name*:_________________ Middle _____________ Last ________________________

* Please include full first, middle and last names.

Position(s)/Seat(s) applying for: _____ [insert Youth Seat (non-voting)]

_____ [insert Youth Seat Alternate (non-voting)]

Home Address

Address 1: ____________________________________________________________________

Address 2: ____________________________________________________________________

City:____________________________ State: _______________ Zip Code: ______________

Home Phone:____________________________ Home Fax: ___________________________

Student Cell Phone: ____________________________________________________________

Student E-mail: ________________________________________________________________

Parent/Guardian Cell Phone: ____________________________________________________

Parent/Guardian E-mail: ________________________________________________________

Parent/Guardian Acknowledgement:

I acknowledge that I am aware of and support my son/daughter or ward applying for and potentially serving on the [insert site] National Marine Sanctuary Advisory Council.

Parent/Guardian Printed Name: _________________________________________________

Parent/Guardian Signature: _____________________________________________________

Date: ________________________________________________________________________

Please answer all of the questions below thoroughly and in numerical order. Answers should appear on a separate attached document with each answer clearly marked with the corresponding question number.

1. Why are you interested in serving on the sanctuary advisory council?

2. Explain your views regarding the protection and management of marine or Great Lake resources, including natural (fish, coral reefs, etc.), historic and/or cultural resources.

3. Describe what you think is the role of the council, and how you will work to best support the sanctuary as a sanctuary advisory council member or alternate.

4. How much time do you have and are you willing to give to sanctuary advisory council activities (e.g., meetings, constituent outreach, retreats and reviewing written materials)? Please address whether it is possible for you to miss a portion of or all of your classes and club or team activities to attend a sanctuary advisory council meeting or retreat?

5. Explain how you will share information with your peers in the community, take action on council-related issues, etc.

6. Describe what knowledge and experience you can bring to the advisory council, which may include, but is not limited to, other groups you belong to or affiliations you have (e.g., student council, science club, soccer team, hiking club, scouts, employment). Be sure to include qualifications that you have or relevant information that you think would be beneficial to the council.

7. How long have you lived in the community or area affected by the sanctuary? Please address whether you are a year-round or seasonal resident of the area.

Individuals 18 years of age and older are not eligible to apply for the sanctuary advisory council’s youth seat, but may apply for other council seats as they become open and are advertised.

Information obtained through this application process will be used to determine the qualifications of the applicant for membership on the sanctuary advisory council. The Office of National Marine Sanctuaries intends affirmatively to disclose the applications only to Department of Commerce/National Oceanic and Atmospheric Administration staff and other members of the applicant review panel. However, the Office of National Marine Sanctuaries may be required to disclose the applications in response to a court order, a congressional request, or a request from the public under the Freedom of Information Act (FOIA).

If disclosure is requested under FOIA, the Office of National Marine Sanctuaries will endeavor to protect the privacy of applicants by withholding personal information, such as home addresses and telephone numbers. In contrast, statements of philosophy or opinions contained in the application would likely be released. Applying for membership on the sanctuary advisory council is voluntary.

Public reporting burden for this collection of information is estimated to average one hour per response, including the time for reviewing instructions, searching existing data sources, gathering the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Office of National Marine Sanctuaries, 1305 East West Highway, N/NMS, Silver Spring, Maryland 20910.

Notwithstanding any other provision of law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act, unless that collection of information displays a currently valid OMB Control Number.

Privacy Act Statement

Authority: Section 315 of the National Marine Sanctuaries Act (NMSA) (16 U.S.C. § 1445a) authorizes the establishment of national marine sanctuary advisory councils, for which this information is needed for determining appointments.

Purpose: NOAA’s Office of National Marine Sanctuaries collects this information for the purpose of reviewing and selecting candidates for specific seats on national marine sanctuary advisory councils. Such information may include, among other things, name and other contact information, formal professional and community affiliations, employment and expertise and experience relevant to the goals and uses of the sanctuary, and the seat(s) for which the individual is applying.

NOAA Routine Uses: NOAA will use this information to determine selection of advisory council members. Disclosure of this information is permitted under the Privacy Act of 1974 (5 U.S.C. Section 552a) to be shared among NOAA staff for work-related purposes, as well as with a subset of advisory council members. Disclosure of this information is also subject to all of the published routine uses as identified in the Privacy Act System of Records Notice Commerce/DEPT-11, Candidates for Membership, Members, and Former Members of Department of Commerce Advisory Committees.

Disclosure: Furnishing this information is voluntary; however, failure to provide the information will prevent individuals from being considered or selected for a National Marine Sanctuary Advisory Council seat.

OMB Control #0648-0397

Expires 06/30/2018