Southington Land Conservation Trust, Inc.
PO Box 369
Southington, CT 06489
Please enroll me/us in the membership category listed below: (circle)
Category
Individual: $20.00
Family: $30.00
Supporting: $50.00
Life: $300.00
Name:_____________________________________
Address:
__________________________________________
City:_____________________ State:______Zip:__________
Home Phone:_______________
Work Phone:_______________
Email:___________________
Cell Phone:________________
