Opacum Land Trust Membership & Support

Please select one of the following:
This is from an Individual_____ Business_____      if yes, please fill in below:
Business Name:__________________
Include a link to my business website: www.____________________________

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Membership Categories:
Please select your membership level:
Donor Categories:
If you are able to make an additional donation: 
_____ One Year, $25 _____Land Regent, $1000 or more
_____ Two Years, $40 _____Land Guardian,  $500
_____ Three Years, $50 _____Land Conservator, $250
_____ Senior annual, (60+), $20 _____Land Preserver, $100
_____Land Protector, $50
_____Land Steward, $___________

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Please complete the following information:
Name:_____________________________________________
Address:__________________________________________
             ____________________________________________
City, State, Zip:______________________________________
Phone:_____________________________________________
E-mail:______________________________________________
By giving us your e-mail address, we can inform you of events and breaking news.  Opacum Land Trust does not share or distribute e-mail addresses.
Please check the following that apply:
_____My Employer has a matching gift program 
           Company Name:______________
____Please do not share my name.
_____Please contact me regarding a planned giving program. ____Please do not list my name in publications.
_____I am interested in learning more about Conservation Options for my property.
_____I would like to learn more about volunteering with OLT.  My interests are

Any annual contribution will make you a member for that year.  OLT is a 501(c)(3) non-profit organization, all contributions are tax deductible.
Please make checks payable to Opacum Land Trust, and mail with this membership form to:

Opacum Land Trust
P.O. Box 233
Sturbridge, MA 01566
Thank you for your support!