Membership and Donation Form

Our membership year runs from July 1 - June 30

Memberships accepted at any time, any amount!

Please print and complete this page and mail it with your check, payable to Bolton Land Trust, to:

Laurie Brooks, Treasurer

55 Hebron Road, Bolton, CT  06043

I would like to be a member of the Bolton Land Trust, and enclose the following membership contribution (check one):

Student or Senior Citizen (age 55 or older): $15____
Individual: $25____
Family: $35____
Corporate/Business: $100____
Other donation: $____
Matching donation from another source: $____

Name_______________________________________________________________
Address_____________________________________________________________
E-mail (used to send monthly Musing and notices of events)___________________

Phone ________________