Dd Form 2932 - National Language Service Corps (Nlsc) Application

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FOR NLSC USE ONLY

OMB No. 0704-0449

NATIONAL LANGUAGE SERVICE CORPS (NLSC) APPLICATION

CONTROL NUMBER

OMB approval expires

Nov 30, 2018

PLEASE RETURN YOUR COMPLETED FORM TO:

NATIONAL LANGUAGE SERVICE CORPS, P.O. BOX 12221, ARLINGTON, VA 22219-2221

The public reporting burden for this collection of information is estimated to average 18 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 the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate, Information Management

Division, 4800 Mark Center Drive, Alexandria, VA 22350-3100 (0704-0449). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any

penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PRIVACY ACT STATEMENT

AUTHORITY: 10 U.S.C. 131, Office of the Secretary of Defense; DoD Directive 5124.02, Under Secretary of Defense for Personnel and Readiness (USD(P&R));

50 U.S.C. 1913, National Language Service Corps.

PRINCIPAL PURPOSE(S): To allow U.S. citizens with language skills to self-identify their skills for the purpose of temporary employment on an intermittent work

schedule or service opportunities in support of DoD or another department or agency of the United States. The information will be used to determine applicants' eligibility

for NLSC membership and to identify and contact NLSC members. Submitted forms are covered by Privacy Act System of Records Notice DHRA 07, National Language

Service Corps ( ).

ROUTINE USE(S): In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974, as amended, the records or information therein

may be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a(b)(3) as follows:

To another department or agency of the United States in need of temporary short-term foreign language services, where government employees are required or desired.

The DoD Blanket Routine Uses found at may apply to this collection.

DISCLOSURE: Voluntary; however, failure to provide information may result in non-enrollment in the NLSC and refusal to grant access to member areas of the NLSC

portal.

SECTION I - PERSONAL INFORMATION

1.a. TITLE

b. LAST NAME

c. FIRST NAME

d. MIDDLE NAME

e. NICKNAME

(X one)

MS.

MR.

MRS.

DR.