Fillable Dd Form 2793 - Volunteer Agreement Form printable pdf download

Submit Application

VOLUNTEER AGREEMENT FOR

APPROPRIATED FUND ACTIVITIES

NONAPPROPRIATED FUND INSTRUMENTALITIES

PRIVACY ACT STATEMENT

AUTHORITY: Section 1588 of Title 10, U.S. Code, and E.O. 9397.

PRINCIPAL PURPOSE(S): To document voluntary services provided by an individual, including the hours of service performed, and to

obtain agreement from the volunteer on the conditions for accepting the performance of voluntary service.

ROUTINE USE(S): None.

DISCLOSURE: Voluntary; however failure to complete the form may result in an inability to accept voluntary services or an inability to

document the type of voluntary services and hours performed.

PART I - GENERAL INFORMATION

TYPED NAME OF

VOLUNTEER

SSN

DATE OF

BIRTH

(Last, First, Middle Initial)

(YYYYMMDD)

INSTALLATION

ORGANIZATION/UNIT

WHERE SERVICE OCCURS

PROGRAM WHERE SERVICE

OCCURS

ANTICIPATED DAYS

OF WEEK

ANTICIPATED HOURS

DESCRIPTION

OF VOLUNTEER SERVICES

PART II - VOLUNTEER IN APPROPRIATED FUND ACTIVITIES

10. CERTIFICATION

I expressly agree that my services are being provided as a volunteer and that I will not be an employee of the United States

Government or any instrumentality thereof, except for certain purposes relating to compensation for injuries occurring during the

performance of approved volunteer services, tort claims, the Privacy Act, criminal conflicts of interest, and defense of certain suits arising

out of legal malpractice. I expressly agree that I am neither entitled to nor expect any present or future salary, wages, or other benefits

for these voluntary services.

I agree to be bound by the laws and regulations applicable to voluntary

service providers and agree to

participate in any training required by the installation or unit in order for me to perform the voluntary services that I am offering.

I agree to

follow all rules and procedures of the installation or unit that apply to the voluntary services I will be providing.

a. SIGNATURE OF VOLUNTEER

DATE

SIGNED (YYYYMMDD)

11.

a. TYPED NAME OF ACCEPTING OFFICIAL

SIGNATURE

c. DATE SIGNED (YYYYMMDD)

(Last, First, Middle Initial)

PART III - VOLUNTEER IN NONAPPROPRIATED FUND INSTRUMENTALITIES

12. CERTIFICATION

I expressly agree that my services are being provided as a volunteer and that I will not be an employee of the United States

Government or any instrumentality thereof, except for certain purposes relating to compensation for injuries occurring during the

performance of approved volunteer services and liability for tort claims as specified in 10 U.S.C. Section 1588(d)(2). I expressly agree

that I am neither entitled to nor expect any present or future salary, wages, or other benefits for these voluntary services. I agree to be

bound by the laws and regulations applicable to voluntary service providers, and agree to participate in any training required by the

installation or unit in order for me to perform the voluntary services that I am offering.

I agree to follow all rules and pro

cedures of the

installation or unit that apply to the voluntary services

that I am offering.

a. SIGNATURE OF VOLUNTEER

DATE

SIGNED (YYYYMMDD)

13.

a. TYPED NAME OF ACCEPTING OFFICIAL

SIGNATURE

c. DATE SIGNED (YYYYMMDD)

(Last, First, Middle Initial)

PART IV - TO BE COMPLETED AT END OF VOLUNTEER'S SERVICE BY VOLUNTEER SUPERVISOR

15. SIGNATURE

16. TERMINATION DATE

14. AMOUNT OF VOLUNTEER TIME DONATED

(YYYYMMDD)

a. YEARS (2,087

WEEKS

c. DAYS

HOURS

hours=1 year)

17.

a. TYPED NAME OF SUPERVISOR

SIGNATURE

c. DATE SIGNED (YYYYMMDD)

(Last, First, Middle Initial)

DD FORM 2793, FEB 2002

PREVIOUS EDITION IS OBSOLETE.

Exception to Standard Form 50 granted by

Reset

Office of Personnel Management (OPM) waiver.

Dd Form 2793 - Volunteer Agreement Form

Related Articles

Related forms

Related Categories