You will be accessing a U.S. Government Information system. This information system is provided for U.S. Government authorized use only. Unauthorized or improper use of this system may result in disciplinary action, as well as civil and criminal penalties. By using this information system, you understand and consent to the following;
- You have no reasonable expectation of privacy regarding any, communication or data transiting or stored on this information system.
- At any time, and for any lawful government pupose, the government may, monitor, intercept, and search and seize any communication or data, transiting or stored on this information system.
By logging in to this system, you acknowledge that you are aware of the consent requirements presented above for accessing U.S. Government systems.
Privacy Act Statement
This information is provided pursuant to Public Law 93-579 (Privacy Act of 1974), December 21, 1984, for individuals completing this form.
African American Civil Rights Network Act of 2017 (PL115-104).
Purpose and Uses:
The U.S. Civil Rights Network was established, in part, to facilitate sharing of information among those interested in the African American Civil Rights Movement. Putting people in contact with others who are researching related topics, historic events, or individuals or who may have technical expertise or resources to assist with projects is one of the most effective means of advancing African American Civil Rights history commemoration and preservation. Privacy laws designed to protect individual contact information (i.e., home or personal addresses, telephone numbers, fax numbers, or e-mail addresses), may prevent NPS from making these connections. If you are willing to be contacted by others working on civil rights movement activities and to receive mailings about African American civil rights movement-related events, please add a statement to your letter of consent indicating what information you are willing to share. The DOI and NPS may use the information to meet reporting requirements, to generate budget estimates and track performance, and to assist park staff with visitors’ education, fee collection, resource management and protection, recreational use planning, law enforcement and public safety personnel for such purposes as emergency contact and search and rescue efforts; to provide permit holders and participants with information about parks and their partners; and to provide reports of activities conducted under an issued permit.
Voluntary. However, failure to provide the requested information may impede our ability to process your application. It is in your best interest to answer all of the questions. The U.S. Criminal Code, Title 18 U.S.C. 1001, provides that knowingly falsifying or concealing a material fact is a felony that may result in fines of up to $10,000 or 5 years in prison, or both. Deliberately and materially making false or fraudulent statements on this form will be grounds for not approving your application.
Paperwork Reduction Act Statement
The authority to collect this information is the African American Civil Rights Network Act of 2017 (PL115-104). We will use this information pilot test the on-line form used to evaluate properties, facilities, and programs nominated for inclusion in the U.S. Civil Rights Network. We may not conduct or sponsor and you are not required to respond to a collection of information unless it displays a currently valid OMB control number. Your response is required to obtain or retain a benefit. OMB has approved this collection of information and assigned control number 1090-0011.
Estimated Burden Statement
Public reporting for this collection of information is estimated to average 30 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 Information Collection Officer, National Park Service, 12201 Sunrise Valley Dr. (MS-242), Reston, VA 20192.