America’s Natural and Cultural Resources Volunteer Portal
VOLUNTEER APPLICATION
Campground Volunteer
You are applying for:
POSITION:
Campground Volunteer
SITE:
Molly Stark State Park
OMB No 0596-0080 Expires 12/2013
Download Application Form
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
*
12
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3. Telephone Number
*
4. Email Address
*
5. Street Address 1
*
Address 2 (include apartment no., if any)
6. City
*
State
*
Zip Code
*
Non-USA
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Mariana Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Virgin Islands
Washington
West Virginia
Wisconsin
Wyoming
7. Which general volunteer work categories are you most interested in?
*
Campground Host
Computers
Trail/Campground Maintenance
Visitor Information
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. Are you a United States Citizen?
Yes
No (NON-US CITIZENS: click
HERE
for additional information)
11. a. Have you volunteered before?
Yes
No b. If Yes, please briefly describe your volunteer experience.
12. Would you like to supervise other volunteers?
Yes
No
13. What are some of your objectives for working as a volunteer? (optional)
14. Please specify any physical limitations that may influence your volunteer work activities
*
15a. Which months would you be available for volunteer work?
*
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
15b. How many hours per week would you be available for volunteer work?
*
Hours
15c. Which days per week would you be available for volunteer work?
*
MON
TUE
WED
THU
FRI
SAT
SUN
16. Specify at least three states or specific locations within a state where you would like to do volunteer work
17. 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
18. If a volunteer assignment is not available at the
Campground Volunteer
, 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.
19. This is provided for more detailed responses. Please indicate the item numbers to which these responses apply
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 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. 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 and injury compensation. Furnishing this data is voluntary, however if this form is incomplete, enrollment in the program cannot proceed.
Optional Form 301 (Revised 6/2008)
USDA-USDI
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