OF Form 301 (Rev. 12/18/2018) |
OMB Control. No. 1093-0006 |
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Expiration Date 11/30/2021 |
VOLUNTEER SERVICE APPLICATION—NATURAL & CULTURAL RESOURCES
The volunteer application helps public lands officials and potential volunteers determine if there are volunteer opportunities that are a good match for the skills and interests identified. All volunteers are required to complete a volunteer agreement once they have identified and committed to a specific volunteer activity. Mark in the appropriate boxes and print or type all responses.
1.Name (Last, First, Middle)
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 |
□ Public speaking |
□ Heavy equipment operation |
□ |
Research/Librarian |
□ Horses – care/ riding |
□ |
Sign language |
□ Landscaping/Reforestation |
□ |
Supervision |
□ Land surveying |
□ |
Other trade skills (Please specify) |
□ Livestock/Ranching |
□ Teaching |
□ Map reading or GIS/GPS |
□ Working with people |
□ Mountaineering |
□ Writing/Editing |
□ Photography |
□ Other (Please specify) |
11.If you have a specific volunteer interest, please identify and describe your qualifications, skills, experiences, or education that may apply.
12.CITIZENSHIP/RESIDENCY STATUS
□U.S. Citizen or Legal Alien/Permanent Resident
□Foreign National, list visa type ___________________
13.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
15.What are some of your objectives for volunteering? (Optional)
16.Please list any physical limitations that may impact your volunteer activities.
Volunteer Service Application |
OF301 |
USDA-USDI-DOC-DOD |
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Page 1 of 3 |
|
OF Form 301 (Rev. 12/18/2018) |
OMB Control. No. 1093-0006 |
|
Expiration Date 11/30/2021 |
VOLUNTEER SERVICE APPLICATION—NATURAL & CULTURAL RESOURCES
17.Which months are you available to volunteer? Check all that apply.
□ January |
□ February |
□ March |
□ April |
□ May |
□ June |
□ July |
□ August |
□ September |
□ October |
□ November |
□ December |
17b. How many hours per week would you be available for volunteer work? Hours ______ |
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17c. Which days are you available to volunteer? Check all that apply. |
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□ Monday □ Tuesday □ Wednesday □ Thursday |
□ Friday □ Saturday □ Sunday |
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18.Specify states or locations where you would like to volunteer.
19.Specify your lodging needs:
□I will furnish my own lodging (such as tent; camper; own, relative’s, or friend’s place)
□I will require assistance in finding lodging
20.If a volunteer assignment is not available at the location specified in box #16, do you want your application forwarded to another location or Federal agency seeking volunteers with your background or interests?
□Yes □ No (Please specify)
21.How did you hear about this volunteer opportunity? Check all that apply.
□ Volunteer.gov |
□ Brochure |
□ Other internet or website |
□ Volunteer fair or event |
□ Advertisement |
□ Other (specify) |
□ Word of mouth (friend, colleague, family member |
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22. Signature |
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23. Date |
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Volunteer Service Application |
OF301 |
USDA-USDI-DOC-DOD |
|
Page 2 of 3 |
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OF Form 301 (Rev. 12/18/2018) |
OMB Control. No. 1093-0006 |
|
Expiration Date 11/30/2021 |
NOTICES
PRIVACY ACT STATEMENT
Authority:
•16 U.S.C. §1721 et. seq. – Public Lands Corps Act (PLC)
•16 U.S.C. §4601 – Outdoor Recreation Authority
•16 U.S.C. §558 a-d – Volunteers in the National Forests Program
•16 U.S.C. §583j – Forest Foundation Volunteers
•16 U.S.C. §1246 – Administration and development of national trails system
•16 U.S.C. §1250 – Volunteer trails assistance
•31 U.S.C. §3325 – Authorizes payment of vouchers
•38 U.S.C. §4301 – The Uniformed Services Employment and Reemployment Rights Act
•16 U.S.C. §1246(h)(1) – Agreements to Operate, Develop, and Maintain Portions of National Trails
•54 U.S.C. §101702(a) Cooperative Agreements, Transfer of Service Appropriated Funds
•54 U.S.C. §101702(b) Cooperative Agreements, Cooperative Research and Training Programs
•Presidential Memorandum -- Expanding National Service, July 15, 2013
•Department of the Interior Secretary Order No. 3333
Purpose: To allow eligible individuals to participate in sponsored volunteers and youth programs events, positions, and programs for federal agencies mandated to manage public natural and cultural resources.
Routine Uses: Participating federal agencies personnel will use this information to determine an individual’s eligibility for placement, validate hours of service, and verify results of volunteer and youth related programs.
Disclosure: Furnishing this information is voluntary; however, failure to furnish this information may impede your reservation or program entry for programs offered by sponsor agencies.
PAPERWORK REDUCTION ACT STATEMENT
In accordance with the Paperwork Reduction Act (44 U.S.C. 3501), the U.S. Department of Agriculture (USDA) and U.S. Department of the Interior (USDI) collect information necessary to manage the security, safety, reporting, recruitment, placement, training, on boarding, benefits, and experience of volunteers and related youth programs. Information requested in this form is purely voluntary. 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 currently valid OMB control number. OMB has approved this collection of information and assigned Control No. 1093-0006.
ESTIMATED BURDEN STATEMENT
We estimate public reporting for this collection of information to average 15 minutes, including time for reviewing instructions, gathering and maintaining data and completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of the information collection to the Information Collection Clearance Officer, U.S. Department of the Interior, 1849 C Street, NW (OCIO-PPMD), Washington, DC 20240.
NOTICE TO PROGRAM PARTICIPANTS
By signing this application, the program participants (s) understand(s) s/he may be subject to a reference check, background check, and/or criminal history inquiry. Volunteers are not considered Federal employees for any purposes other than tort claims and injury compensation as per agency guidelines. Volunteers and related program participants are encouraged to verify with local sites all working conditions. Volunteer service is not creditable for leave accrual or any other benefit. However, volunteer service is creditable work experience.
The federal government prohibits 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 (i.e. youth programs may have age limits by law). To file a complaint of discrimination, write DOI, Director, Office of Civil Rights, 1849 C Street, NW, Mail Stop 4359, Washington, District of Columbia, 20240, Voice (202)-208-5693 FedRelay:800-877-8339. Fax: 202-208-6112. The Federal Relay Service (FedRelay) allows individuals who are deaf, hard-of-hearing, deaf/blind, or have speech disabilities to have equal communication access. Calls are relayed using specially trained Communications Assistants.
Volunteer Service Application |
OF301 |
USDA-USDI-DOC-DOD |
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