Please complete this form to make a one-time Membership or Annual Fund (above and beyond membership) gift - and help save the outdoors for all to experience. Thank you for your generosity!
To make monthly, recurring gifts and become an Evergreen Member, please
use this form
To make a
gift in honor or in memory of a loved one, please
use this form
One-Time Gift
Amount
35.00
50.00
75.00
100.00
250.00
500.00
1000.00
Member Type
New Membership
Renew Membership
Annual Fund (above membership dues)
NEW Members: If someone referred you to SELT, please enter their name(s) here:
Contact Information
First Name(s)
(If you have the same last name as your spouse,
please enter both names here eg: John and Joan)
Last Name
Spouse/Partner First Name (if different from your own)
Spouse/Partner Last Name (if different from your own)
Company Name
Address
City
State/Province
Zip/Postal Code
Home Phone
Work Phone
Email
Optional: Processing Fees
Simply leave "Yes!" checked below to increase your contribution by 3% to cover the processing fees for online giving. Thank you!
Yes! I will cover transaction fees for my donation. I will contribute $0.00.
No thank you. Please proceed with my contribution of $0.00.
Credit Card Information
Card Holder Name
Visa
MasterCard
Discover
American Express
Card Account Number
Expiration Date
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
24
25
26
27
28
29
30
31
32
33
34
Security Code
Billing Address
Same As Above
Address
City
State/Province
Zip/Postal Code
Next
SELT, Southeast Land Trust of New Hampshire, is a 501 (c)(3) nonprofit organization. All contributions are tax-deductible to the extent allowable by law.
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Contact Us
: Southeast Land Trust of New Hampshire • PO Box 675, Exeter, NH 03833 • 603/ 778-6088
[email protected]
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