Online Membership Form

Membership Form

 

Please find enclosed my/our tax deductible gift to Loon Echo Land Trust in the amount of $______________.

 

$50 Land Saver

$75 Land Partner

$100 Land Protector

$250 Land Steward

$500 Land Conservator

$1000 Land Trustee

$2500 Keeper of the Land

$5000 Guardian of the Land

$_________ Other

 

Payment Options:

Please see the enclosed check.

Please charge my credit card: Amount $_______________     Visa            Mastercard.

Account #: _______________________________________ Exp Date: ______________

 

Donor Information:

Name(s) ________________________________________________________________

Address ________________________________________________________________

City _______________________________ State __________________ Zip __________

Phone _____________________________

Email___________________________________________________________________

 

Optional Information:

In honor or memory of: ____________________________________________________

How did you learn about Loon Echo? _________________________________________

 

Thank you for your membership contribution!

 

Please send to:

 

Loon Echo Land Trust, 8 Depot St., Ste. 4 Bridgton, Maine 04009
207-647-4352   –   info@lelt.org   –   www.lelt.org