Volunteer Services Application

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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 X 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.       
    15. Would you like to supervise other volunteers?     Yes    No  
    16. What are some of your objectives for volunteering? (Optional)       
    17. Please list any physical limitations that may impact your volunteer activities.     
    18. 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 
    19. Specify states or locations where you would like to volunteer.     
    20. Specify your lodging needs:
   I will furnish my own lodging                         I will require assistance in finding lodging
    21. 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)       
    22. 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
Completing this form is voluntary, but failure to provide the information will prevent program participation. 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 1093-0006. 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 is covered by Privacy Act System of Records INTERIOR/DOI–05 Interior Volunteer Services File System (which may be viewed at https://www.doi.gov/privacy/doi-notices) and OPM/GOVT–1 General Personnel Records (which may be viewed at https://www.opm.gov/information-management/privacy-policy/#url=SORNs) and is 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, managing the volunteer program, including tort claims and injury compensation. Records or information contained in this system may be disclosed outside the agencies participating in this program as a routine use pursuant to 5 U.S.C. 552a(b)(3. Completing this form is voluntary, but failure to provide the information will prevent program participation.
    23. Signature 
21.  Date