Please fill out and print this form and send it with your donation to:

Skagit Land Trust
PO Box 1017
Mount Vernon, WA 98273

Your Membership Information
 

Select your Membership Level
 

$5000 Major Donor $2500 Steward $1000 Conservator $500 Benefactor $250 Patron $100 Sponsor $60 Supporter $40 Partner $30 Friend  Business memberships start at $60. 

Select your Payment Method
 

Enclosed is a check for $

I wish to charge $ One Time

I wish to pledge $ Monthly  Quarterly 

          Visa/Mastercard #  ---   Expires mo 01 02 03 04 05 06 07 08 09 10 11 12 /       year 2006 2007 2008 2009 2010 2011 2012  

          Name as it appears on card:

          Signature for credit card charge:
 
          ________________________________________  Date: ___________

          Your charges will be confirmed on your bank or credit card statement.
          Of course, you may change or discontinue your contribution at any time by calling or writing Skagit Land Trust.

Additional Information
 

I would like additional information on:
          Donating land or conservation easements
          Donating stocks or equipment
          Including Skagit Land Trust in my will
          Making a memorial gift
          Hosting a presentation
          Obtaining materials suitable for schools

Skagit Land Trust is a 501(c)(3) organization, federal tax ID number 91-1533402. Your annual membership contribution is tax-deductible.