Loading ...
Global Do...
News & Politics
4
0
Try Now
Log In
Pricing
EARTH TEAM VOLUNTEER INTEREST AND PLACEMENT SUMMARY DATE:____________________ NAME:_______________________________________________________________________________________ LAST FIRST MIDDLE ADDRESS:____________________________________________________________________________________ STREET ______________________________________________________________________________________________ CITY STATE/PROVINCE ZIP/POSTAL PHONE NUMBER AND AREA CODE: HAVE YOU EVER DONE VOLUNTEER WORK? ___ BUSINESS ( )___________________ WHERE?____________________________ HOME ( )_______________________ WHAT KIND?_______________________ HIGHEST ACADEMIC COMPLETED: GRADES: 1 __ 2 ___3 ___4 ___5 ___6 ___7 ___8 ___9 ___10 ___11 ___12 COLLEGE: ___1 ___2 ___3 ___4 DEGREE:______________ MAJOR:___________________________ OCCUPATION:_______________________________________________________________________________ INTEREST, SKILLS, HOBBIES___________________________________________________________________ SPECIAL TRAINING____________________________________________________________________________ 1 of 2 WHAT TYPE OF VOLUNTEER WORK WOULD YOU LIKE TO DO FOR CONSERVATION? 1. OUTDOOR ACTIVITY_____ 4. CLERICAL_________ 7. COMPUTER___________ 2. TEACHING______________ 5. PHOTOGRAPHY____ 8. MEDIA SERVICES_____ 3. PUBLIC SPEAKING_______ 6. WRITING __________ 9. OTHER, ______________ WHAT IS YOUR AREA OF AVAILIBILITY? CITY__________ COUNTY_______ STATE____ DATE OF AVAILABILITY_______________ HOW MUCH TIME CAN YOU GIVE? WEEKLY__________ MONTHLY___________ WHY DO YOU WANT TO WORK FOR NRCS?_____________________________________________________________________________ WHERE DID YOU LEARN ABOUT EARTH TEAM VOLUNTEERS? TV_____ RADIO_____ NEWSPAPER_____ FRIEND_____ OTHER___________________ Privacy Act Statement This information is provided to comply with the Privacy Act (PL 93-579). U.S.C. 301 and 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. OMB Disclosure Statement Public reporting burden for this collection of information is estimated to vary from 5 to 45 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, Washington D.C. 20250 and to the Office of Management and Budget, Paperwork Reduction Project (OMB No 0578-0024) Washington, D.C. 20503. To volunteer in New Jersey - MAIL TO: STATE EARTH TEAM COORDINATOR USDA-NRCS 220 Davidson Ave, 4th Floor Somerset, NJ 08873 2 of 2 EARTH TEAM VOLUNTEER INTEREST AND PLACEMENT SUMMARY http://www.ny.nrcs.usda.gov/earthteam/interest.htm
