VOLUNTEER ACCOMPLISHMENT REPORT
Project Leader or Supervisor: _____________________________________________________
Project/Position/Type of Activity: __________________________________________________
Number of Individuals (Do not list names): __________________________________________
Total Hours Worked: ____________________________________________________________
Miles driven in Private Vehicles: ___________________________________________________
Work Accomplished: ____________________________________________________________
Estimate the age and gender of participants. Indicate the number of participants for each
category in the table below.
Age 20 and under
Age 55 and above
Estimate the race/ethnicity of participants. Indicate the number of participants for each category
in the table below.
Race/Ethnicity: White (non Hispanic)
Race/Ethnicity: Black (non Hispanic)
Race/Ethnicity: American Indian/Alaskan Native
Race/Ethnicity: Asian/Pacific Islander
Cost Data (Forest Service Use Only)
How would this activity normally be done? Check appropriate box.
For contract work, estimate the amount that would be paid to a contractor for comparable work.
For force account work, include direct costs.
Employee Wages: $________________________________________
($______per hour x ______hours = $_____)
Supervision Wages: $________________________________________
($ _____per hour x ______hours = $______)
Supply Costs: $_____________________________________________
Vehicle costs: $_____________________________________________
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.