New Canaan Land Trust · Evergreen Society Pledge Form

STATEMENT OF INTENT

Name *

First Name

Last Name

Please recognize me as a member of the Evergreen Society in the following way: *

(Optional) Name for recognition purposes, if different from above:

First Name

Last Name

Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Email *

Verify Email *

I would like to be interviewed about my story so that my example may inspire others *

Yes

No

I intend to include the NCLT in my will or estate planning through: *

Other (please specify):

I wish for my gift to be directed towards: *

Other (please specify):

Optional: Comments, specific instructions: