Name *

E-Mail: *

Address *

Town or City *

State or Province *

Zip or Postal Code *

Telephone

Membership Individual($10) Family ($25) Business ($25) *

If Family Membership Yes No

If Business Membership Yes No

Do you have an Additional Address Yes No

Eventually you will be able to pay for your membership on-line through PayPal. For now you need to send us a check via US Mail. Checks should be made out to : South Hero Land Trust, PO Box 455, South Hero, VT 05486

Please enter the letters and numbers in the image. If you cannot read the image, click the red square at the upper right corner of the yellow input box for a new image.