Form OF-301 Volunteer Services Application

OMB 0596-0080 v1

VOLUNTEER SERVICE APPLICATION—NATURAL & CULTURAL RESOURCES

This optional application helps federal land and water management agencies identify interested and qualified candidates for available volunteer positions. Applications are submitted and processed locally for each position. If a volunteer commits to a specific volunteer activity, they are required to complete an OF-301a Volunteer Service Agreement. Mark R in the appropriate boxes and print or type all responses.

1. Name (Last, First)     

2. Date of Birth

    /     /     

3. Telephone Number (   )     -     

4. Email Address     

5. Street Address, Apt. #     

6. City

7. State

8. ZIP code

9. Which general categories are you most interested in volunteering? Check all that apply.

Archaeology

Botany

Campground/Site host

Campground maintenance

Construction maintenance

Computers

Conservation education

GIS/GPS

Fish/Wildlife

Historical/Preservation

Pest/Disease control

Minerals/Geology

Natural resources planning

Office/Clerical

Range/Livestock

Research/Librarian

Soil/Watershed

Timber/Fire prevention

Trail maintenance

Tour guide/Interpretation

Visitor information

Other (Please specify)      

10. What qualifications, skills, or experiences do you have that you would like to use as a volunteer? Check all that apply.

Backpacking/Camping

Biology

Boat operation

Carpentry

Clerical/Office machines

Computer programming

Drafting/Graphics

Driver’s license

First aid certificate

Hand/Power tools

Heavy equipment operation

Horses – care/ riding

Landscaping/Reforestation

Land surveying

Livestock/Ranching

Map reading or GIS/GPS

Mountaineering

Photography

Public speaking

Research/Librarian

Sign language

Supervision

Other trade skills (Please specify)     

Teaching

Working with people

Writing/Editing

Other (Please specify)      

11. What languages are you proficient in? Check all that apply.

Arabic

Chinese

English

French

German

Hindi

Japanese

Korean

Lahanda/ Punjabi

Portuguese

Russian

Spanish

Other (Please specify)      

12. If you have a specific volunteer interest, please identify and describe your qualifications, skills, experiences, or education that may apply.

13. Are you a United States Citizen or Permanent Resident?

Yes, I am a U.S. citizen or Permanent Resident      No, I am not a US Citizen or Permanent Resident      (if applicable, list visa type____________)

14. a. Have you volunteered before? Yes No

b. If yes, please list the organization where you volunteered with a contact name and phone # or email address, and briefly describe what you did.      

14. Would you like to supervise other volunteers? Yes No

14. What are some of your objectives for volunteering? (Optional)      

14. Please list any physical limitations that may impact your volunteer activities.     

14. a. Which months are you available to volunteer? Check all that apply.

January

July

February

August

March

September

April

October

May

November

June

December

18b. How many hours per week would you be available for volunteer work? Hours    

18c. Which days are you available to volunteer? Check all that apply.

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

14. Specify states or locations where you would like to volunteer.     

14. Specify your lodging needs:

I will furnish my own lodging I will require assistance in finding lodging

14. Are you willing to have your application forwarded to other federal offices or agencies, if no opportunity exists at the location to which you applied, and if there are known alternatives appropriate to your interests and experience?

Yes No (Please specify)      

14. How did you hear about this volunteer opportunity? Check all that apply.

Volunteer.gov Other website Advertisement Word of mouth (friend, colleague, family member)

Brochure Volunteer fair or event Other (Please specify)      

Burden Statement

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0596-0080. The time required to complete this information collection is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The U.S. Department of the Interior (USDOI), U.S. Department of Agriculture (USDA), U.S. Department of Defense (USDOD), and U.S. Department of Commerce (USDOC) are equal opportunity providers and employers and prohibit discrimination in all programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation, and marital or family status. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means of communication of program information should contact the volunteer program to which they are applying. If you would like to file a Section 508-related complaint, please contact the DOI Section 508 Program via email at [email protected] or phone (202) 208-1530.

Notice to Volunteer

Volunteers are NOT considered Federal employees except as otherwise provided by law. Volunteer service is not creditable for leave accrual or any other benefit. However, volunteer service is creditable work experience. By signing this application the volunteer(s) understand(s) they may be subject to a reference check, background check, and/or criminal history inquiry.

Privacy Act Statement

Collection and use are covered by Privacy Act System of Records DOI-05 and OPM/GOVT-1 and are consistent with the provisions of 5 USC 552a (Privacy Act of 1974), which authorizes acceptance of the information requested on this form. The information is used to identify persons interested in participating in a government volunteer program and to manage the volunteer program, including tort claims and injury compensation. Furnishing this information is voluntary, however, failure to provide the requested information will prevent program participation.

14. Signature

21. Date      

Volunteer Service Application OF301 USDA-USDI-DOC-DOD