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VOLUNTEER APPLICATION  Camp Host

OMB No 0596-0080  Expires 8/2010
Download Application Form Download Volunteer Application Form in PDF format   Download Volunteer Application Form in Microsoft® Word™ format

Volunteer Application
for Natural Resource Agencies		 Instructions: Please complete this form and then click the Review button. * Required Information
1. Last Name *First Name *Middle
2. Age *
3. Telephone Number *
4. Email Address *
5. Street Address 1 *Address 2 (include apartment no., if any)
6. City *State *Zip Code *
7. Which general volunteer work categories are you most interested in? *

Campground Host   Trail/Campground Maintenance   General Assistance  
8. What qualifications/skills/experience/education do you have that you would like to use in your volunteer work? *

Backpacking/Camping Heavy Equipment Operation Sign Language
Biology Horses-Care/Riding Supervision
Boat Operation Landscaping/Reforestation Other Trade Skills
Carpentry Land Surveying Teaching
Clerical/Office Machines Livestock/Ranching Other Trade Skills
Computer Programming Map Reading Working with People
Drafting/Graphics Mountaineering Writing/Editing
Driver's License Photography  Other
First Aid Certificate Public Speaking  
Hand Power Tools Research/Librarian  
9. Based on boxes checked in items 7 and 8. what particular type of volunteer work would you like to do? (Please describe any specific qualifications, skills, experience, or education that apply) *
10.  a. Have you volunteered before? Yes   No     b. If Yes, please briefly describe your volunteer experience.

  
11. Would you like to supervise other volunteers? Yes   No
12. What are some of your objectives for working as a volunteer? (optional)
13. Please specify any physical limitations that may influence your volunteer work activities *
14a. Which months would you be available for volunteer work? *

JAN   FEB   MAR   APR   MAY   JUN   JUL   AUG   SEP   OCT   NOV   DEC
14b. How many hours per week would you be available for volunteer work? *   Hours

14c. Which days per week would you be available for volunteer work? *

MON   TUE   WED   THU   FRI  SAT   SUN
15. Specify at least three states or specific locations within a state where you would like to do volunteer work
16. Specify your lodging requirements

I will furnish my own lodging (such as tent; camper; own, relatives', or friends' place)
I will require assistance in finding lodging
17. If a volunteer assignment is not available at the Camp Host, do you want your application forwarded to another location or Federal agency seeking volunteers with your background/interests?

Yes. Please forward my application.     No. Do not forward my application.
18. This is provided for more detailed responses. Please indicate the item numbers to which these responses apply
    
Public Burden Statement
Public reporting burden for this collection of information 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. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Agriculture, Clearance Officer, OIRM. Room 404-W, Washington DC 20250; and to the Office of the Management and Budget, Paperwork Reduction Project (OMB# 0596-0080), Washington, DC 20503.

Notice to Volunteer
Volunteers are not considered to be Federal employees for any purposes other than tort claims and injury compensation. Volunteer service is not creditable for leave accrual or any other benefit. However, volunteer service is creditable work experience.

Privacy Act Statement
Following information is provided to comply with the Privacy Act (PL 93-579). 5 U.S.C. 301 and 7 CFR 260 authorize acceptance of the information requested on this form. The data will be used to contact applicants and to interview, screen, and select them for volunteer assignments. Furnishing this data is voluntary.

Optional Form 301 (Revised 8/2004)

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