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Mail-in Membership Form

Please print this page, and then fill out the information below:
Please accept membership dues for the current year. (Any donation of over $25.00 is greatly appreciated) $ _____ .00
Please accept a donation to the Capital Fund for Bass River Park purposes. $ _____ .00

Name: ________________________________________________________

Mailing Address: ________________________________________________

______________________________________________________________

Address: ______________________________________________________

______________________________________________________________

City: __________________________________________________________

State: _________________________ Zip Code: ______________________

Other (Summer/Winter) Address: ___________________________________

______________________________________________________________

Phone: ________________________________________________________

Fax: __________________________________________________________

Email: _________________________________________________________

May we correspond with you via e-mail? Yes: ___ No: ___

I would like to volunteer: my interests are (circle all that apply)
newsletter; website; fundraising; special projects; property overseeing.
Please provide me with more information on how to deed land to the Trust
Please provide me with more information on gifts and bequests to the Trust.

Donation in honor or in memory of ________________________
Please notify the person of my donation
Name: _______________________________________________
Address: _____________________________________________
_____________________________________________________

I have a matching gift program with my employer, and have forwarded the forms to you.
Your tax-deductible contribution should be made out to: Dennis Conservation Trust
Mail this page to:
Dennis Conservation Trust
P.O. Box 67
East Dennis, MA 02641
 Thank you for your interest!