Harry C. Barnes Memorial Nature Center  Indian Rock Nature Preserve

Hart Nature Reserve Shepard Nature Preserve Shangri-La Preserve

 

 Corporate Membership Application

 

Name:                         ______________________________________________

 

Address:                     ______________________________________________

 

City, State, ZIP          ______________________________________________

 

 Phone:                        ______________________________________________

 

Corporate Membership Classes:   

 

                                    ________ Benefactor                           $5,000.00

                                    ________ Patron                                 $2,500.00

                                    ________ Sustaining                            $1,000.00

                                    ________ Sponsor                              $   500.00

                                    ________ Donor                                 $   250.00

                                    ________ Friend                                 $   100.00

 

I grant permission for the Environmental Center to use our company’s name and membership class for use in publications, brochures, wall plaques, and other media to acknowledge our membership. 

I do not want our company’s name used in acknowledgement of our membership.

 

 

_________________________________________             _____________

Company Representative

Date

                                                         

_________________________________________

Printed Name of Company Representative

 

 

Your contribution is tax deductible as allowed by law under section 501 (c) (3) of the Internal Revenue Service Code.

 

Please make contributions payable to:               ELCCT

                                                                        501 Wolcott Rd.

                                                                        Bristol, CT 06010

 

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