Tract Number:	Parcel:
Submitted By:	Date Submitted:
The Virginia Forest Stewardship Program has been established to provide services that will meet the needs of the forest landowners. The Stewardship Program focuses on providing a customized forest management plan to meet your forestland ownership objectives. The information on this application will help the Forester develop a stewardship plan that meets your objectives.
SECTION 1 – Applicant Information
Last Name:	First Name:
Mr.	Mrs.	Ms.
Mailing Address:
City:	State:	Zip:
Home Phone:	Work Phone:
E-mail:	Cell Phone:
SECTION 2 – Tract Information
County:	Tract Name:
Tract Location: (include tax map id)
Total Tract Acres:	Acres of Forested Land:
Is this tract your primary residence?	Yes	No	If no, how many days per year are spent on the tract?
Is this tract a Certified Tree Farm?	Yes	No	If No, would you like information about Tree Farm?	Yes	No
Are you the sole owner of the property?	Yes	No
If no, please list the other owners.
How long have you owned this forested land?	1 year	2-5 years	6-15 years	16 or more years
Have you ever harvested timber from this tract?	Yes	No
Do you own forestland in other Virginia counties?	Yes	No
If yes, please list counties and number of forested acres.
If you own other forested land, have you ever harvested timber from these tracts?	Yes	No
Have you ever received professional forestry advice about managing your forested lands?	Yes	No
If yes, from whom?
What did you receive professional forestry assistance for? (check all that apply)
Preparing a Forest Management Plan
Timber Sales or Harvesting (timber marking, sales assistance, timber valuation, etc.)
Forest Stand Management (thinning, prescribed burn, pruning, herbicide application, etc.)
Reforestation and Planting
Wildlife Management
Other (specify)

SECTION 3 – Landowner Objectives
Please rank the five most important objectives you want to consider in your Stewardship Management Plan, where number 1 indicates the most important and number 5 is relatively less important.
Maintenance of a Scenic Forest	Wildlife Habitat
Wildlife for Hunting	Real Estate Investment
Managing Timber for Income (to sell timber)	Protect Rare, Unique Natural Areas
Forest Stand Management (maintain health of forest)	Historical / Cultural Resources
Non-Wildlife Related Outdoor Recreation (Hiking, Non-Motorized Trail Biking, Horseback Riding, etc.)	Soil and Water Conservation
Other (specify)
If you are interested in managing for wildlife, please rank the five most important species you are most interested in, where number 1 indicates most important and number 5 is relatively less important.
Deer / Turkey	Rabbits
Squirrel	Bobwhite Quail
Songbirds	Water Fowl
Rare, Threatened or Endangered Species (Plants or Animals)	Fur Bearers (Fox, Raccoon)
Other (specify)
Is this property under a conservation easement?	Yes	No
If yes, who holds the easement?
If no, would you like information about conservation easements?	Yes	No
An extensive plan appendix document is available as a reference to your Forest Stewardship Plan. How would you like to access this plan appendix?
Electronic – Internet Link (pdf 35 mb)	Printed Copy with My Plan
SECTION 4 – Landowner Agreement
I understand:
That I am encouraged to implement recommended practices as I am able but I am not required to. That it is my option to have a Forest Stewardship Management Plan prepared by any forester who has completed a certified Virginia Forest Stewardship Training Course as approved by the State Forester.
Check if you would like a VDOF forester to develop this Stewardship Plan. If yes, I agree to:
Pay the Department of Forestry $1.50 per acre for every acre under the plan that is developed by the VDOF forester, with a minimum charge of $200 per plan. Pay the Department within thirty (30) days of the date on the initial billing. Invoices not paid within 30 days are subject to a late payment penalty fee of 10% per annum. If the total amount due is not paid within 60 days, an additional 20% service fee will be added to the unpaid balance and it will be sent to a collection agency.
Landowner Name (Print)	Landowner Signature	Date
SECTION 5 – Forest Stewardship Management Plan to be Prepared By
Agency or Company (Print)	E-mail	Phone Number
Forester Name (Print)	Forester Signature	Date
Return completed application to the forester designated to prepare the Stewardship Plan.