B No. 0596-0080
Expires 10/31/2021
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.
Name (Last, First, Middle)
3. Telephone Number
4. Email Address
City, State, and Zip Code
Which general categories are you most interested in volunteering? Check all that apply.
Botany Fish/Wildlife Soil/Watershed
Campground/Site host Historical/Preservation Timber/Fire prevention
Campground maintenance Pest/Disease control Trail maintenance
Construction maintenance Minerals/Geology Tour guide/Interpretation
Computers Natural resources planning Visitor information
Conservation education Office/Clerical Other (Please specify)
What qualifications, skills, or experiences do you have that you would like to use as a volunteer? Check all that apply.
Hand/Power tools
Public speaking
Biology Heavy equipment operation Research/Librarian
Boat operation Horses care/ riding Sign language
Carpentry Landscaping/Reforestation Supervision
Clerical/Office machines Land surveying Other trade skills (Please specify)
Computer programming Livestock/Ranching Teaching
Drafting/Graphics Map reading or GIS/GPS Working with people
Driver’s license Mountaineering Writing/Editing
First aid certificate Photography Other (Please specify)
9. If you have a specific volunteer interest, please identify and describe your qualifications, skills, experiences, or education that
may apply.
10. Are you a United States Citizen? Yes No (If no, additional information may be required)
11. 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.
12. Would you like to supervise other volunteers? Yes No
13. What are some of your objectives for volunteering? (Optional)
Please list any physical limitations that may impact your volunteer activities.
Volunteer Service Application OF301 USDA-USDI-DOC-DOD
OMB 0596-0080
Approved October 2018
15. a.
Which months are you available to volunteer? Check all that apply.
July August September October November December
15b. How many hours per week would you be available for volunteer work? Hours
15c. Which days are you available to volunteer? Check all that apply.
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
16. Specify states or locations where you would like to volunteer.
17. Specify your lodging needs:
will furnish my own lodging (such as tent; camper; own, relative’s, or friend’s place)
I will require assistance in finding lodging
18. If a volunteer assignment is not available at the location specified in box #16, do you want your application forwarded to
other location or Federal agency seeking volunteers with your background or interests
s No (Please specify)
19. How did you hear about this volunteer opportunity? Check all that apply. Brochure
Other internet or website Volunteer fair or event
Advertisement Other (specify)
Word of mouth (friend, colleague, family member
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 Agriculture (USDA) and U.S. Department of
the Interior 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 for
communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at 202-720-2600 (voice and TDD). To file a
complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, DC 20250-9410 or call (800) 795-3272
(voice) or (202) 720-6382 (TDD). USDA and USDI are equal opportunity providers and employers.
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) s/he 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 OPM/GOVT-1 and USDA/OP-1, 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 data will be used to maintain official records of volunteers of the USDA and
USDI for the purposes of tort claims, injury compensation, and other volunteer claims allowed by law. Furnishing this data is voluntary, however if this form is
incomplete, enrollment in the program cannot proceed.
20. Signature 21. Date
Volunteer Service Application OF301 USDA-USDI-DOC-DOD
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