Information about the Opportunity

Name

Host Name

Location

Date

Please add any relevant experience you have that we should know about.

How did you hear about this opportunity?

This activity is not currently accepting registrations. Contact ATC Staff with any questions.

First Name

Middle Name or Initial

Last Name

Nickname

Phone

Street

City

State

Zip Code

Date of Birth

Dietary Restrictions

YesNo

If yes, please describe:

Type(s) of Interest (select all that apply)

Select location(s) to give ATC permission to email you future volunteer, training, or recreation activities. (select all that apply)

North (ME, NH, VT, MA, CT. NY, NJ)Central (NY, NJ, PA, MD, WV, VA)South (WV, VA, TN, NC, GA)Trailwide

More about you:

I am a Veteran

Gender Identity

Ethnicity/Race (select as many as apply to how you most closely identify)

Certifications

Please add any Certifications you may have, as well as the date certified, expiration date (if applicable) and the party that oversaw the certification process.

Type

Course Completion Date:

Expiration Date

Certification Delivered by (organizational entity):

Evaluator

Begin typing an Evaluator name to search

Evaluator Id

Card Signator

Begin typing a Card Signator to search

Card Signator Id

A.T. Club Affiliation related to this certification, if any

Begin typing a club name to search

A.T. Club Affiliation Id

Add any relevant attachment. (jpg, jpeg, png or pdf)

Upload file

Volunteer Service Agreement Sign On

All volunteers that participate with an organized group on an episodic volunteer project on a unit of a public lands agency must be signed up on this form. By signing this form you agree to the terms of the project as defined in the attached Volunteer Service Agreement and affirmed by the organization and federal agency represents. Volunteers under age 18 must complete a Volunteer Service Agreement—Natural & Cultural Resources and must be signed by the parent or guardian. Please indicate your willingness (yes) or unwillingness (no) for the Agency to use your photographic, video or audio images in performance of volunteer duties.

References: Volunteer Service Agreement Packet

Volunteer Safety Page and JHA Library

Signature of agreement and acknowledgement: (please write out your full name)

Are you willing for the Agency to use your photographic, video, or audio images in performance of volunteer duties?

YesNo

Are you willing for the Appalachian Trail Conservancy to use your photographic, video, or audio images in performance of volunteer duties?

YesNo

Burden Statement: According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0596-0080. The time required to complete this information collection is estimated to average 1.9 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.

Placeholder 1

Placeholder 2

Placeholder 3

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Email

Emergency Contact Phone

School and Parent/Guardian Information

What school do you go to?

Parent or Guardian Name

Parent or Guardian Email

Parent or Guardian Phone Number

2nd Parent/Guardian Emergency Contact Name and Phone

Name

Phone

I have sent the Administrator/Teacher Endorsement Link to my admin/teacher.

Yes

I have discussed this program with my guardian/parents and they have agreed for me to participate. **We will send parent permissions after selections are made.

YesNoMaybe

Reasonable Accommodation

Before responding to the question below, please reference the Essential Eligibility Criteria found within the How to Hike the A.T. web page. If you feel you might need a Reasonable Accommodation to participate in a course, an ATC staff member will contact you directly to discuss what those might be.

Do you feel you might need a Reasonable Accommodation to participate in this course?

YesNo

Edit this text

Volunteers are invited to create an account to join our online community, A.T. Stewardship. Joining makes registering for future opportunities easy and helps you track your accomplishments. Indicate below if you'd like access. Then check your inbox for an email (with the subject line “Welcome to the A.T. Stewardship Community!”) to set up your account.

Please add me to the online volunteer community

Click "Continue" to continue expressing your interest with event host

Click "submit" to continue to your payment screen