Land Trust Alliance Donation Form
Land Trust Alliance Donation Form When you give to the Land Trust Alliance, you help people in your community and across America protect the lands that enrich your life—ensuring clean air and water, sustaining locally grown food, inspiring you with natural beauty, and providing you with special places to explore. Individuals who make annual contributions at the $1,000 level or higher are welcomed into the Guardians of the Land Society. Thank you for your support! Donation Amount: o
$35
o
$50
o
$75
o
$100
o
$250
o
$500
o
$1,000
o
Other: ________
Name: _______________________________________________________________________________ Email: _______________________________________________________________________________ Address: _____________________________________________________________________________ City: ____________________________________ State: ____________ Zip Code: ________________ Phone: _______________________________________
Fax: _________________________________
Are you on the board of a land trust? If yes, tell us which land trust(s): _____________________________________________________________________________________
Check No.: ____________ OR Credit Card Type (circle one): Visa
MasterCard
Discover
American Express
Credit Card Number: _____________________________________ Expiration Date: ________________ Cardholder’s Name: ____________________________________________________________________ Please send your completed form to the Land Trust Alliance Development Office, 1250 H St. NW, Ste 600, Washington, DC 20005, by email at [email protected] or by fax to (202) 638-4730. 1250 H Street NW, Suite 600, Washington, DC 20005-3952 202-638-4725
Phone
| 202-638-4730
Fax
| www.landtrustalliance.org
$35
o
$50
o
$75
o
$100
o
$250
o
$500
o
$1,000
o
Other: ________
Name: _______________________________________________________________________________ Email: _______________________________________________________________________________ Address: _____________________________________________________________________________ City: ____________________________________ State: ____________ Zip Code: ________________ Phone: _______________________________________
Fax: _________________________________
Are you on the board of a land trust? If yes, tell us which land trust(s): _____________________________________________________________________________________
Check No.: ____________ OR Credit Card Type (circle one): Visa
MasterCard
Discover
American Express
Credit Card Number: _____________________________________ Expiration Date: ________________ Cardholder’s Name: ____________________________________________________________________ Please send your completed form to the Land Trust Alliance Development Office, 1250 H St. NW, Ste 600, Washington, DC 20005, by email at [email protected] or by fax to (202) 638-4730. 1250 H Street NW, Suite 600, Washington, DC 20005-3952 202-638-4725
Phone
| 202-638-4730
Fax
| www.landtrustalliance.org
