Sandhills Area Land Trust Memberhship Form

Membership Application
(Tax Deductible)

Name: (required)	(Last)	(First)
Mailing Address:

City/Town:
State:
Zip Code:
Home Phone: (required)	i.e., (xxx)xxx-xxxx
Work Phone:	i.e., (xxx)xxx-xxxx
E-mail Address: (required)	i.e., xxx...@yy...y.nnn

I would like to join as a (Select a membership level):

Basic Membership Level $30-$99 Steward of the Land $100-$249 Protector of the Land $250-$499 Guardian of the Land $500-$999	The Conservation Legacy $1,000-$4,999 The Longleaf Legacy $5,000-$9,999 The Great Sandhills Legacy $10,000+
Contribution Amount:

Payment type (Select one):

Check or money order
Credit card

If paying by check or money order please send payment to:

Sandhills Area Land Trust
P.O. Box 1032
Southern Pines, NC 28388

Credit Card Type
Visa
Mastercard

Name on Card:
Card Number:
Expiration Month:
Expiration Year:

Membership Application (Tax Deductible)

Membership Application
(Tax Deductible)