Home • Membership

Verde Valley Land Preservation Institute
Membership Application

Type:

____ Annual, Individual ($25)
____ Annual, Family ($40)
____ Annual, Business ($50)
____ Life, Bronze ($250)
____ Life, Silver ($500)
____ Life, Gold ($1000)
____ Life, Platinum ($5000)
(Please make checks payable to Verde Valley Land
 Preservation Institute)

All Memberships and donations are tax deductible under the 501[c](3) tax status.
Donations over and above the designated membership amounts will be received with 
our gratitude.

First Name

____________________________________________________

Last Name

____________________________________________________

Company

____________________________________________________

Address

____________________________________________________

City

____________________________________________________

State

____________________ Zip Code ______________________

Telephone

____________________________________________________

Fax

____________________________________________________

Email

____________________________________________________

The Verde Valley Land Preservaton Institute is a non-profit
corporation organized to serve the region through Open Space
Planning, Acquisition and Management.

____ Please indicate if you would like to be a volunteer
     to assist the Institute

Print this form and mail to:

Verde Valley Land Preservation Institute 
P.O. Box 3356 
Cottonwood AZ 86326