Chapter Application Heartwood Chapter Application 2026 Application to attend the next Training Session. Class size is limited. To ensure space, please submit early. "*" indicates required fields Date MM slash DD slash YYYY Name* First Last Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code County of residence Montgomery Walker Harris Other Cell Phone*Email* Name of Emergency Contact*Contact's Phone*Class List Inclusion Approval* Name Cell phone Email address City Zip Code Select AllWe would like provide to the class a list of the attendees and their contact information. Please designate what information we may include from you. Getting to know you…Please explain your interest in the Master Naturalist volunteer program.Please explain your interest in the Master Naturalist volunteer program.What are some organizations for which you have volunteered in the past? How many hours per month did you volunteer for each?Please indicate skills, professional training, or interests you could share as a Master Naturalist: Education and/or Public Outreach (Speaking, nature guide, environmental educator, project development) Field Activities and/or Research (Monitoring/ surveys, plant/wildlife census, habitat restoration/planting, water quality testing, bird/butterfly counts, seed/plant collections, invasive species monitoring/removal) Administration (Chapter committee member/chair, newsletter editing/reporting, website updating, computer assistance, fundraising) Select AllDo you possess other skills or interests not specified above? Please be specific.Please specify how you wish your name to appear on your name tag and certification form.*Upon completion of initial certification requirements, you will receive a shirt with the TMN logo. Please select your size: (These are men's sizes.)* Small Medium Large XLarge XXLarge XXXLarge How did you hear about us? Facebook Instagram Website Heartwood Booth Word of mouth From Current Member Other If you heard about us from a Current Member, please supply their name so we can thank them.Program Requirements and ConsentsTraining Requirements* I acknowledge that I am able to attend the scheduled training classes and field trips. I understand that I must complete a minimum of 40 hours of initial training to graduate.Certification Requirements* I understand that I will be required to complete at least 40 hours of approved volunteer service and 8 hours additional, approved advanced training to qualify for Certification as a Texas Master Naturalist within 15 months of the start of the Primary Training Session.Maintaining Certification* I understand that to maintain the status as a Certified and Active member of the Texas Master Naturalist program, I must complete a minimum of 40 hours of approved volunteer service and 8 hours of approved advanced training. I must also pay chapter dues for each calendar year after initial certification to remain active.Consent* In consideration of being accepted as a participant in the Texas Master Naturalist Volunteer Program of the Heartwood Chapter, I hereby release, discharge and agree to hold harmless the Program and its sponsoring state Agencies, their agents, employees, officers and successors for all personal injuries including death, and/or known and unknown damage to property caused by or arising out of activities performed under this program.Consent* I understand that a mandatory criminal background check will be run by the TMN program.Minimum Age Requirement for participation* I am 18 years or older.Social Media* I agree that my picture may be used in social media and/or the website.Contact Information I agree to share my contact information with the class.Electronic Signature* Δ
