Parkers Creek Conservation Society (PCCS) Membership Application

Parkers Creek Conservation Society (PCCS) Membership Application

Updated October 2025
Name*

First NameLast Name
Preferred Phone Number*

Area CodePhone Number
Email*
example@example.com
Address**

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
*Please note that applicants who live more than 40 miles from the American Chestnut Land Trust (ACLT) office located at 676 Double Oak Road, Prince Frederick, MD 20678 will not be considered for PCCS membership.
QUESTIONS:
Are you currently a licensed hunter?*

YesNo
If yes, how long have you been a hunter?*
Which deer season(s) do you wish to hunt?*

BowShotgunMuzzleloader
Are you a current ACLT member?*

YesNoNot sure
Have you ever been charged with a Department of Natural Resources violation? If yes, please explain.*
How did you learn about ACLT and the PCCS?*
Occupation*
Skills & Experience: Membership in the PCCS requires completing 20 service hours at ACLT each year. This can include but is not limited to hiking trail maintenance, facilities maintenance, invasive plant control, outreach, and farm work. Please indicate if you have any training or experience in any of the following: carpentry, plumbing, electrical work, using equipment such as chainsaws and weed whackers or large equipment such as bobcats/skid steers, gardening, education, outreach, science, or any other relevant fields/skills.*
PERSONAL REFERENCE:
Personal Reference Name*

First NameLast Name
Personal Reference Email*
example@example.com
Personal Reference Phone Number*
Please enter a valid phone number.
Personal Reference Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please note that completion of an application does not mean acceptance into the PCCS. Interest in PCCS membership is high and space is limited. New hunters are accepted based on the relevant skills they can contribute through service hours at ACLT, their ACLT membership status (priority will be given to members), and the distance between their residence and the ACLT office (priority will be given to those who live closer to ACLT). Acceptance is also determined by the current number of vacancies in the PCCS.

Applicants may be asked to complete an interview conducted by the PCCS President and ACLT staff. Applicants may also be subject to a criminal background check.

ACLT and the PCCS do not discriminate with regard to race, religion, national origin, gender, sexual orientation, or age.

Questions? Email landmanager@acltweb.org

NOTE: All applications must be submitted by November 9, 2025
Signature*

Clear
Date*

MonthDayYear
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Parkers Creek Conservation Society (PCCS) Membership Application

PERSONAL REFERENCE: