General Council Application

National Marine Sanctuary Advisory Council Application Form

National Marine Sanctuary Advisory Council
Application Form
Before applying for sanctuary advisory council membership, please review:
(1) the sanctuary advisory council charter provided in your application kit, and;
(2) the Office of National Marine Sanctuaries (ONMS) Sanctuary Advisory Council
Implementation Handbook available online at
http://www.sanctuaries.noaa.gov/management/ac/acref.html (or you may obtain a copy
from your local sanctuary – see contact information below).
The charter outlines the purposes and governs the operation of the sanctuary advisory council.
The handbook provides broader operational requirements for sanctuary advisory councils. In
applying for sanctuary advisory council membership, you are agreeing to abide by the terms of
the charter and the handbook if you are selected as a council member or alternate.
As a part of the selection process, please note the Office of National Marine Sanctuaries will
conduct a LEXIS/NEXIS check and a departmental bureau check for potential conflict of interest
and other issues in your background.
Additionally, as per guidance from the White House Office of Management and Budget on May
7, 2009, the Office of National Marine Sanctuaries will conduct a database search (via the
Senate’s Lobbying Disclosure Act Database) to determine if you have been a federally registered
lobbyist. Individuals, who have been a federally registered lobbyist in the two year period before
the proposed appointment date for the advertised council seat(s), may not be selected as an
advisory council member or alternate.
Additional information and guidance regarding the use of the information you submit on this
form and its availability under federal law can be found at the end of this form. Please review
this information.
Sanctuary advisory council members and alternates must be 18 years of age or older, with
the exception of individuals filling youth seats.
Please note that federal government employees are not allowed to sit on sanctuary advisory
councils in a personal capacity. State employees and members of a state legislature are allowed
to apply to sit on sanctuary advisory councils in a personal capacity. State agency employees
must provide a letter of support on official agency letterhead from their state supervisor at the
time they submit their applications. Members of state legislatures are not required to provide
such letters of support.

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National Marine Sanctuary Advisory Council Application Form

Please indicate which advertised seat(s) (e.g., Research, Education) and position(s) (i.e., council
member or alternate) you are applying for, provide your contact information, and respond to the
questions below. The Office of National Marine Sanctuaries may consider applicants for seats
and positions for which they have not applied if the Office of National Marine Sanctuaries
believes they are qualified for that seat and are willing to serve in it.
The application deadline is [insert date]. Please return all pages of your completed sanctuary
advisory council application form, and any attached statements or documents, to [insert local
contact information].

Date: __________________
First Name*:______________ Middle _____________ Last ___________________________
* Please include full first, middle and last names.

Position(s)/Seat(s) applying for: _____ [insert advertised seat and position]
_____ [insert advertised seat and position] _____ [insert advertised seat and position]
____ [insert advertised seat and position] _____ [insert advertised seat and position]

Home Address
Address 1: ____________________________________________________________________
Address 2: ____________________________________________________________________
City:____________________________ State: _______________ Zip Code: ______________

Home Phone:____________________________ Cell Phone: ___________________________
Home Fax: ______________________________ Home E-mail: _________________________

Work Address
Company/Organization: _________________________________________________________
Position/Job Title: ______________________________________________________________

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National Marine Sanctuary Advisory Council Application Form

Address 1: ____________________________________________________________________
Address 2: ____________________________________________________________________
City:____________________________ State: _______________ Zip Code: ______________

Work Phone:___________________________ Work Cell: ____________________________
Work Fax: _____________________________ Work E-mail: _________________________

Please thoroughly address each of the following in an attached statement, by number, in the same
order as below:
1. Why are you interested in serving on the sanctuary advisory council?
2. Explain your views regarding the protection and management of marine or Great Lake
resources, including natural (fish, coral reefs, etc.), historic or cultural resources.
3. Describe your particular expertise and experience as it relates to the goals and uses of the
sanctuary and, in particular, the seat(s) for which you are applying. Be sure to include
qualifications that you have or other information that you think would be relevant and
beneficial to the sanctuary advisory council.
4. Describe what you think is the role of the council, and how you will work to best support
the sanctuary as a sanctuary advisory council member or alternate.
5. Describe your formal community and professional affiliations and employment.
6. Explain how you will coordinate with, consult with, and inform the members of the
constituency you will represent, if appointed.
7. How much time do you have and are you willing to give to participate in sanctuary
advisory council activities (e.g., meetings, constituent outreach, retreats, chairing or
participating on a subcommittee or working group, and reviewing written materials)?
8. How long have you lived in the community or area affected by the sanctuary? Please
address whether you are a year-round or seasonal resident of the area.
9. Have you attended previous sanctuary advisory council meetings or sanctuary advisory
council working group meetings? If so, please describe your past attendance and
participation.

Information obtained through this application process will be used to determine the qualifications
of the applicant for membership on the sanctuary advisory council. The Office of National

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National Marine Sanctuary Advisory Council Application Form

Marine Sanctuaries intends affirmatively to disclose the applications only to DOC/NOAA staff
and other members of the applicant review panel. However, the Office of National Marine
Sanctuaries may be required to disclose the applications in response to a court order, a
congressional request, or a request from the public under the Freedom of Information Act
(FOIA).
If disclosure is requested under the FOIA, the Office of National Marine Sanctuaries will
endeavor to protect the privacy of applicants by withholding personal information, such as home
addresses and telephone numbers. In contrast, statements of philosophy or opinions contained in
the application would likely be released. Applying for membership on the sanctuary advisory
council is voluntary.
Public reporting burden for this collection of information is estimated to average one hour per
response, including the time for reviewing instructions, searching existing data sources, gathering
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 Office of National Marine Sanctuaries, 1305 East West
Highway, N/NMS, Silver Spring, Maryland 20910.
Notwithstanding any other provision of law, no person is required to respond to, nor shall any
person be subject to a penalty for failure to comply with, a collection of information subject to the
requirements of the Paperwork Reduction Act, unless that collection of information displays a
currently valid OMB Control Number.

OMB Control #0648-0397
Expires TBD

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