U.S. DEPARTMENT OF THE INTERIORBUREAU OF LAND MANAGEMENT
UNITED STATES DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
Washington, DC 20240
May 9, 2011
In Reply Refer To:
1114 (172) P
EMS TRANSMISSION 05/11/2011
Instruction Memorandum No. 2011-109
To: All Washington Office and Field Office Officials
Attn: Volunteer Coordinators, Resource Program Leads, and Forms Coordinators
From: Director, National Landscape Conservation System and Community Partnerships
Subject: New Volunteer Agreement Form and Volunteer Recordkeeping Reminder
Program Area: Volunteers
Purpose: The purpose of this Instruction Memorandum (IM) is to advise appropriate BLM staff of the availability of a new Volunteer Agreement form and to remind them of their record keeping responsibilities.
Policy/Action: New Volunteer Agreement Form and Volunteer Recordkeeping
New Volunteer Agreement Form
A new form, “Volunteer Services Agreement Form for Natural Resources Agencies – for Individuals or Groups” (Optional Form 301a), replaces BLM’s volunteer agreement 1114-4 (individual) and 1114-5 (group) forms. The new form has been developed based on an earlier version by the members of the Federal Interagency Team on Volunteerism (comprised of staff from the Bureau of Land Management, U.S. Fish and Wildlife Service, National Park Service, Bureau of Reclamation, U.S. Geological Survey, Bureau of Indian Affairs, U.S. Forest Service, National Oceanographic and Atmospheric Administration, and U.S. Army Corps of Engineers). The new form is available at the GSA forms website (http://www.gsa.gov/portal/forms/download/37BABF24EBA30684862573A90059902A).
The new form will be phased in over time. It should be used starting immediately for all new volunteers. For current volunteers, Volunteer Coordinators may simply renew the existing form 1114-4 or 1114-5 by renumbering it for the new year, and having the agency representative and volunteer initial any revisions and then sign and date it.
Volunteer Coordinators should make certain that the volunteer’s job description contains details about the skills, limitations, and level of physical activity associated with the assignment (Section 4 on Forms 1114-4 and -5, “Description of service to be performed” on Form 301A) and a signed statement by the volunteer regarding his/her health and ability to meet the physical requirements of the job (Section 4b on Forms 1114-4 and -5, page 2 on Form 301A). All agreements must have a Risk Management Worksheet (BLM Form 1112-5) attached. This form is available at the BLM National Safety Office Website (http://web.blm.gov/internal/wo-700/wo740/riskmanagement.html).
At the end of the fiscal year, as mandated by BLM Volunteer Manual 1114.4, Volunteer Coordinators must terminate expiring volunteer agreements and update and renew agreements that will be ongoing.
Coordinators should make certain that there is emergency contact information (BLM Form 1400-71(296) available as Appendix 1, item 2 at http://www.nifc.gov/safety/investigation_guide/Resource%20Documents/E.%20BLM%20Casualty%20Guide%20(also%20BLM%20Casualty%20Guide%20Website)/BLM%20Employee%20Casualty%20Guide.pdf) in each volunteer’s file in case of an accident. For long-term volunteers (volunteers who report for duty on a regular basis or are engaged in projects lasting more than a week), this information should be kept not only in the volunteer’s file but should also be given to the Field Office’s Duty Officer or the area Dispatch Office. This will assure that emergency contact information can be retrieved, if needed, from agency staff.
Volunteer Coordinators should review the documents in their volunteers’ files. A checklist is provided below; not all of the items will be applicable. Critical components are noted with an asterisk.
_ Completed volunteer agreement (Form 301a, 1114-4, or 1114-5)*
_ Risk Management Worksheet (Form 1112-5)*
_ Copy of volunteer’s driver’s license and driving record check
_ Signed background check form
_ Work schedule*
_ Volunteer hours worked log*
_ Training completed
_ Copy of I-94 for foreign volunteers if receiving reimbursement (for details, see BLM IM 2005-
026, Appendix A)
_ Certificates (ATV, chain saw, drivers safety, etc.) as required by BLM 1114 Manual Section
_ Computer security clearance documentation
_ Signed copy of orientation checklist (http://web.blm.gov/internal/wo-
600/00_wo650_vol/index.html (see “Safety Orientation Checklist for Volunteers” on BLM’s Volunteer Resources Index webpage)
_ “Claim for Reimbursement for Expenditures on Official Business” (Standard Form SF-1164)
_ Copies of evaluations (volunteer and program)
_ Receipt for (government) Property (Form DI-105)
_ Documentation for use of personal horse (BLM Form 1113-1)
_ Photo of the volunteer
_”Personal Emergency Information Card” (BLM Form 1400-71(296))*
Timeframe: This Instruction Memorandum (IM) is effective immediately
Budget Impact: None.
Background: This IM provides information on a new interagency form, “Volunteer Services Agreement Form for Natural Resources Agencies – for Individuals or Groups” (Optional Form 301a), that replaces BLM’s volunteer agreement 1114-4 (individual) and 1114-5 (group) forms. It was developed by the Federal Interagency Team on Volunteerism (FITV) as part of an effort to standardize volunteer programs between agencies and to reduce paperwork. Volunteer Coordinators are also being reminded of their recordkeeping responsibilities for volunteers.
Manual/Handbook Sections Affected: BLM Manual 1114 Sections .07, .13, .42, .53, and .63.
Coordination: This IM was coordinated with the members of the Federal Interagency Team on Volunteerism (comprised of staff from the Bureau of Land Management, U.S. Fish and Wildlife Service, National Park Service, Bureau of Reclamation, U.S. Geological Survey, Bureau of Indian Affairs, U.S. Forest Service, National Oceanographic and Atmospheric Administration, and U.S. Army Corps of Engineers) and the BLM Volunteer Program Adjunct Team.
Contact: If you have any questions, or require additional information regarding this Instruction Memorandum, please contact Shelly Fischman of the Division of Education, Interpretation, and Partnerships at firstname.lastname@example.org or at (202) 912-7453.
Signed by: Authenticated by:
Carl Rountree Robert M. Williams
Director, National Landscape Conservation Division of IRM Governance,WO-560
System and Community Partnerships
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