Phone MEMBERSHIP APPLICATION I want to support Countryside Conservancy’s work in protecting precious land and water resources. Benefits of membership include: our Annual Newsletter; invitations and discounts to Conservancy events; and most of all, the knowledge that you’re helping protect and connect important lands and waters here in our region. Our members are our most important supporters! Countryside Conservancy is a registered 501(c)(3) nonprofit organization, and gifts to the Conservancy are tax-deductible. Contact Information First Name * Last Name * Address (line 1) * Address (line 2) City * State * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Phone number Email Address * Information request I would like to receive information about conserving my land Membership Information Membership Category Individual $35.00 Family $50.00 Friend $100.00 Founder $150.00 Patron $250.00 Benefactor $500.00 Trust Partner $1000.00 Total Total: Disclaimer Countryside Conservancy is a 501(c)(3) nonprofit organization. All contributions to Countryside Conservancy are tax-deductible to the extent allowed by law. OUR WORK PreservesEasementsProtecting Your Lands RESOURCES EventsNewsletters GET INVOLVED MembershipVolunteerWays You Can Help CONNECT About UsContact Us570-945-6995 FollowFollow