Form 3-2349 Alaska Guide Service Evaluation

FWS Form 3-2349 (Rev. 01/2018)
U.S. Department of the Interior

OMB Control. No. 1018-0141
Expiration Date: xx/xx/xxxx

U.S. Fish and Wildlife Service
ALASKA GUIDE SERVICE EVALUATION

As a recent visitor to a national wildlife refuge in Alaska and a client of a refuge authorized guide
service, we ask that you voluntarily complete this survey and return it to us using the enclosed
envelope. You may also return the form via email, facsimile, or in person to the refuge. We will
also accept your responses over the telephone. Your responses will help ensure that refuge
visitors in Alaska receive high quality services and experiences. You will not be contacted for
further information unless you check the box at the end of this form indicating that it is all right to do
so. Please attach additional sheets, if necessary.
1. Your name: _________________________________________________________
2. Name of guide on contract (if applicable): __________________________________
3. Name(s) of guide(s) that assisted you in the field: ____________________________
______________________________________________________________________
4. Activity for which you engaged the guide service (i.e. big game hunting, sport fishing, river or
float trip, etc.):

5. Dates and location of guided activity (river drainage or other significant geographic reference):
______________________________________________________________________
6. Were the guide services provided as advertised or represented? Yes ____ No____
(if no, please explain):
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
7. Did you have any concerns about your personal safety during your guided activities?
Yes ____ No ____ (if yes, please explain)
________________________________________________________________________
_________________________________________________________________________

OMB Control No. 1018-0141
Expires: XX/XX/XXXX

FWS Form 3-2349 (Rev. 01/2018)
U.S. Department of the Interior

8. Do you feel your guide took appropriate actions to minimize impacts on the environment (e.g.,
practicing Leave No Trace techniques)?
Yes ____ No ___ ( (if no, please explain)
______________________________________________________________________
9. Overall, were you satisfied with the guide services provided to you?
Yes ____ No____ (if no, please explain)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

10. Please provide any additional comments you would like regarding this guide service or your
refuge experience:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

Thank you for your input!
May we contact you for more information?

Yes ____ No ____

If yes, please indicate a preferred method for contact (i.e., telephone, mail, email address, etc.).
______________________________________________________________________

OMB Control No. 1018-0141
Expires: XX/XX/XXXX

FWS Form 3-2349 (Rev. 01/2018)
U.S. Department of the Interior

NOTICES
PRIVACY ACT STATEMENT
Authority: The information requested is authorized by the National Wildlife Refuge System Administration
Act (16 U.S.C. 668dd-ee) and the National Wildlife Refuge System Improvement Act of 1997 (P.L. 105-57).
Purpose: The contact information of refuge visitors using a refuge authorized guide service will help gauge
client satisfaction with the services.
Routine Uses: The information will be used by the refuge’s administrative office to evaluate the quality of
services provided by commercial guides on Alaskan National Wildlife Refuges and the impact of the activity
on refuge resources. Information about additional routine uses can be found in the Systems of Records
Notice, FWS-5 National Wildlife Refuge Special Use Permits.
Disclosure: Providing the information is voluntary. All information collected will be aggregated and used
for statistical purposes to evaluate commercial services.
PAPERWORK REDUCTION ACT STATEMENT
We are collecting this information subject to the Paperwork Reduction Act (44 U.S.C. 3501) to help ensure
quality visitor services on national wildlife refuges in Alaska and to respond to requests made under the
Freedom of Information Act and the Privacy Act of 1974. We will aggregate the information and use it only
for statistical purposes. Your response is voluntary. According to the Paperwork Reduction Act of 1995, no
persons are required to respond to a collection of information unless such collection displays a valid OMB
control number. OMB has approved this collection of information and assigned Control No. 1018-0141.
ESTIMATED BURDEN STATEMENT
Public reporting for FWS Form 3-2349 is estimated to be 15 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 this burden, to the
Service Information Collection Clearance Officer, Division of Policy, Performance, and Management
Programs, Fish and Wildlife Service, Mail Stop BPHC, 5275 Leesburg Pike, Falls Church, VA 22041-3803.
Please do not send your completed form to this address.