2020 Membership Form

BECOME A MEMBER

make an investment today

to protect and care for environmentally significant land and water in Waukesha County for future generations.

As a member of the Waukesha County Land Conservancy, you are helping to ensure that Waukesha County’s most irreplaceable natural areas are protected today and for generations to come.

Name*

First Name Last Name

Is this a Family Membership ($100/year)?*

YesNo

List Family Member First and Last Names Included on Membership (up to four total):

E-mail*

Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number*

Area Code Phone Number

Membership*

Student$25.00

must provide current student identification card below

Individual$50.00

Family$100.00

for up to four people

Steward$250.00

Conservation Hero$500.00

Benefactor$1,000.00

Visionary $2,500.00

Legacy$5,000.00

Additional Donation$10.00

$10 increments

Quantity

Total $0.00

Payment Method

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Student Membership ID Card Upload:

Browse Files

Is this a Gift Membership?

YesNo

Gift Recipient Name

First Name Last Name

Gift Recipient Email

example@example.com

Gift Recipient Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Message to Include from Sender to Recipient:

*Environmentally Friendly Option: Check this box if you would like to receive membership materials electronically.

Yes! Save paper and send my membership card electronically via email.