Membership Form for the East Granby Land Trust

Membership Category ____ New Membership_____ Membership Renewal

Check one:

Individual ($25) _____ Corporate ($100) ____

Household ($30) _____ Life Member ($500) _____

Name(s) _________________________________________________________

Address__________________________________________________________

Phone # _______________________ E Mail ____________________________

Check Interest areas :

____ Programs/events ____Membership ____Accessions ____Trails

____ Assessment and Monitoring of Property _____ Publicity

____ Board Position ____Fund Raising ____Rules ____ Publications

____ Clean Up/Clear Out of Property ____ Photo East Granby’s Four Seasons

____ Educational out-reach _____ Meeting refreshments. _____ Signage

____ Other (explain).________________________________________________

Please send form and membership check to:

EAST GRANBY LAND TRUST

P.O. Box 39, East Granby, CT 06026