MSFC 4604 Rover Volunteer Form

NASA Human Exploration
Rover Challenge
Volunteer Sign Up 20XX

Sign up deadline is MM/DD/20XX at
Noon
Parents may signup volunteers ages 13-18 for the same obstacle
position the parent or guardian is working.

Rover Challenge Guide This form is to be completed by civil servants or contractors who wish to

NASA Human
Exploration Rover
Challenge Main Page

register to volunteer to help at the NASA Human Exploration Rover
Challenge. You may also register family members; however children
must be between 13-18 years of age. If you are registering your child to
volunteer, please enter your email address and phone number below. All
fields are required. Please submit a new form for each person you are
registering.
Please note that civil servants and contractors are volunteering for these
positions and may NOT use administrative leave for their time; however,
Marshall Space Flight Center employees who have volunteered to assist
with the NASA Human Exploration Rover Challenge at the U.S. Space
and Rocket Center may be granted up to 4.5 hours of Excused Leave
during their regularly scheduled work day.
Note: Volunteers are notified of their acceptance and provided initial
information regarding shift assignments/dates as well as information for
the date/time/location of the volunteer meeting, which is held prior to the
race, via email.

All fields are required

Name
(Please submit a
new form for each
person)

E-mail Address

Reenter E-mail
Address

First Name

Last Name

Phone
(Must be entered as x-xxxx or xxx-xxxx or xxx-xxxxxxx)

Parent/guardian name for volunteers aged 13 - 18:

Last Name
First Name

Number of Years
Volunteered

(including this year)

Position(s) Requested
— The volunteer schedule for the NASA Human Exploration Rover
Challenge is broken down into four shifts and allows for shift changes.
— You may sign up for multiple shifts.
Note: The number in parenthesis after the position name indicates the
number of openings for that position.

Weekday, Date, [Shift
Time]

Weekday, Date, [Shift Time]

Weekday, Date, [Shift
Time]

Weekday, Date, [Shift Time]

T-shirt Size

S

M

L

XL

2XL

3XL

N

MSFC

Civil Service
Contractor

(Enter Org Code / Contractor Name / Other)

Other

Please mark your calendar the volunteer meeting will be held
[date, time] at the U.S. Space and Rocket Center’s National
Geographic Theater (Davidson Center).

Paperwork Reduction Act Statement
This information collection meets the requirements of 44 U.S.C § 3507,
as amended by section 2 of the Paperwork Reduction Act of 1995. You
do not need to answer these questions unless we display a valid Office
of Management and Budget (OMB) control number. The OMB control
number for this collection is 2700-0157 and this information collection
expires on MM/DD/20XX. We estimate that it will take 3 minutes to
read the instructions, gather the facts and answer the questions. Send
only comments relating to our time estimate to: HQOEIDAdmin1@mail.nasa.gov.

NASA Privacy Statement
This notice provides NASA's policy regarding the nature, purpose, use
and sharing of any information collected via this form. The information
you provide on this NASA-issued form will be used only for its intended
purpose. NASA will protect your information consistent with all applicable
Federal laws, statutes, Government-wide and NASA Policies and
Procedural Requirements. Submitting information is strictly voluntary
and, by doing so, you are giving NASA your permission to use the
information for the specific purpose of planning, coordinating, and
conducting the event. Additionally, the data collected is entered into
NASA's Office of Education Performance Management system, and is
used by Headquarters' staff to respond to reporting requests from NASA
management and others. Data is/may be used in reporting to education
leads in sponsoring NASA mission directorates. If you do not want to
give NASA permission to use your information, simply do not provide it.
However, not providing the requested information may result in NASA's
inability to provide you with the information or services you desire. For
additional details regarding NASA Privacy Policy and Procedures, and
other related information including published NASA Privacy Impact
Assessments (PIAs), please visit the NASA Privacy Policy and Important

Notices Web site at

http://www.nasa.gov/about/highlights/HP_Privacy.html .
For questions, please contact [Name/email], (256) [phone].

MSFC Form 4604

Previous Versions Obsolete