Please complete this form to join the Meriden Land Trust in its pursuit to preserve and maintain open space in Meriden.

MEMBERSHIP RUNS APRIL - MARCH

Name: ________________________________________________

Address:____________________________________________

___________________________________________________

Telephone:_______________________

e-mail:_______________________

___ $20.00 per year, supporting member

___ $25.00 per year, family

___ $50.00 per year, organizational membership

___ $1,000.00 lifetime member

The Meriden Land Trust is a 501(3)(c) nonprofit organization; membership dues are tax deductible.

I am interested in the following activities. Please contact me:

___ Newsletter

___Community Activities

___ Land Stewardship

___ Board of Director Position

___ Publicity

___ Land Acquisition

___ Web site development

___ Membership

___ Fundraising

___ Other _________________________________

For MLT use only:

Thank you for your generous support!

Meriden Land Trust, P.O. Box 1745, Meriden, CT 06450-1745

meridenlandtrust.com