US National Arboretum

 
 

Educational Program Request Form

Thank you for your interest in our educational programs.
Please use this form to submit questions or comments about our workshops, lectures and exhibits.

I have a question or comment about the program entitled:

I would like to know...

I would like to take a course at the Arboretum on these topics related to ornamental plants:
[Please be specific about the topic and the format (workshop, lecture, exhibit, etc.)
and include suggestions for speakers
].


 

If you would like to receive a reply, please provide your contact information, which will not be used for any other purposes, nor provided to any entities outside the U.S. National Arboretum. [If you do not want a reply just leave the fields filled as they are].


Thank you for helping us develop educational programs on topics that interest you.

    

PRIVACY AND PAPERWORK REDUCTION ACT STATEMENTS

Privacy Act Information: This information is provided pursuant to Public Law 93-579 (Privacy Act of 1974) for individuals completing Federal records and forms that solicit personal information. The authority is Title 5 of the U.S. Code, sections 1302, 3301, 3304, and 7201.

Purpose and Routine Uses: The information from this form is used solely to respond to you regarding the service you have requested. No other uses will be made of this information.

Effects of Non-Disclosure: Providing this information is voluntary, however, without it we may not be able to respond to you regarding the service you have requested.

Paperwork Reduction Act Statement: A Federal agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a current valid OMB control number.

Public Burden Statement: Public reporting burden for this collection of information is estimated to vary from two to four minutes with an average to three minutes per response, including time for reviewing instructions, 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, D.C. 20250, and to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, D.C. 20503.

OMB 0518-0032-usna-1 (8/2006)


United States National Arboretum
3501 New York Avenue, NE
Washington, D. C. 20002-1958
Tel: 202-245-2726 Fax: 202-245-4575

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Last updated   November 28, 2007 12:33 PM
URL = http://www.usna.usda.gov/Education/programrequestform.html

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