East Haven Land Trust, Inc.

MEMBERSHIP APPLICATION

Please click your print button then fill out the form below and mail along with check or money order to: East Haven Land Trust- P.O. Box 120354 - East Haven, Connecticut 06512

Name _______________________________________________________

Address ________________________________________________

City ____________________ State ______ Zip _____________

Phone (day)__________________ (eve.) __________________

E-mail ________________________________________________

Enclosed is my tax deductible donation to support EHLT work of preserving East Haven's coast.

Annual Dues

Individual         $10.00
Family             $15.00
Associate        $25.00

Friend $50.00
Patron $100.00

Additional contribution for land acquisition $____________

Please phone me:

I would like to know about volunteer opportunities.
I am considering a land gift or easement.
I am considering a gift of securities.
I am considering naming EHLT in my will.

East Haven Land Trust, Inc. - P.O. Box 120354 - East Haven, Connecticut 06512
Telephone: (203) 467-3292
E-mail: info@easthavenlandtrust.org

Become a member now and know that, with your support, we can work together to preserve our precious coastal environment for generations to come.