Membership in the North Haven Land Trust

You can print this page and mail it to North Haven Land Trust, P.O. Box 262, North Haven, CT 06473

North Haven Land Trust - Membership Application

Name: _________________________________________ Phone: ____________________

Street Address: ___________________________________________________________

Town: ___________________________ State: _________ Zip Code: ______________

• [ ]  Student (under 18 years). . . $ 2.00
• [ ]  Individual. . . . . . . . . . . . . .$ 15.00
• [ ]  Family. . . . . . . . . . . . . . . .$ 20.00
• [ ]  Life. . . . . . . . . . . . . . . . . .$200.00

[ ]  I am enclosing an additional contribution for land acquisition. $ _______

[ ]  I am enclosing an additional contribution to defray operating costs. $ ________

[ ]  I would like to volunteer my time to help the Trust. Please call me.

Dues and contributions are tax deductible.