Please -
use my contribution to support all Orenda's Wildlife Sanctuaries and Land Protection Efforts.

Membership/General Fund:

_____Patron $500    _____Benefactor $250    _____Sponsor $100
_____Family $50    _____Individual $35    _____Other $_______

My additional contribution for Orenda's Land Acquisition Fund: $__________

TOTAL CONTRIBUTION: $__________

Name:______________________________________________

Address:_____________________________________________

Town/City:___________________________________________

State: _____     Zip:_________       Phone:_________________

Method Of Payment
_____Check enclosed (made payable to Orenda Wildlife Land Trust)

_____Credit Card         _____VISA     _____MasterCard

Account Number: __________________________________

Expiration Date: __________

Card Holders Name: ________________________________

Signature: ________________________________________