ACLT Membership Payment Form

Membership Form
Use this form to join ACLT as a new member, renew your membership, or give the gift of membership.
Membership is a meaningful way to support ACLT and help sustain the conservation, stewardship, and community programs that make our work possible.

To submit your payment online, please fill out the form below.

If you would prefer to pay by check, please mail it to:

American Chestnut Land Trust
P.O. Box 2363
Prince Frederick, MD 20678
New MembershipMembership RenewalGift Membership
Your Name*

First NameLast Name
Your Email*
example@example.com
Your Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Spouse's Name

First NameLast Name
Spouse's Email
example@example.com
Spouse's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
List other members' names and relationships (i.e. John Smith - Son):
Total Number of members:
Membership Note (optional)
Gift Membership Notification Name

Who should we notify about your gift? Please list THEIR contact information in the spaces provided below. Note: ACLT will also acknowledge your gift membership in the next newsletter.
Gift Membership Notification Name (i.e. - person receiving the gift membership)*

First NameLast Name
Gift Membership Notification Email*
example@example.com
Gift Membership Notification Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gift Membership Note (optional)

Membership Levels*

Land Saver

A great way to get your boots on the trail. Your support helps protect the woods, wetlands, and wild places that make ACLT special.

$35.00

Land Protector

You’re stepping up for the land. This level helps us safeguard forests, waterways, and the wildlife that call them home.

$60.00

Land Conservator

You’re digging in for conservation. Your generosity fuels the hands-on stewardship that keeps ACLT’s landscapes healthy and thriving.

$150.00

Habitat Protector

You’re making a big impact in the field. This support helps restore critical habitat and protect the rich biodiversity across ACLT lands.

$500.00

Trustee of the Land

You’re helping lead the way forward. Your extraordinary commitment helps ensure these cherished landscapes remain protected for generations of explorers to come.

$1,000.00

Total

$0.00

Payment Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

Membership Form

Gift Membership Notification Name