Mail/Fax Donation Form

SEND DONATIONS TO: The Trust for Public Land
101 Montgomery Street, Suite 900
San Francisco, CA 94104
PHONE 1-800-714-LAND, FAX (415) 495-4103

Please select a gift amount:
($30)____ ($50)____ ($75)____ ($100) ____ ($250)____ ($1000*)____ Other _______
*Stegner Society Level
Mr./Ms./Mrs. ____
Name: _______________________________ Phone: _________________
Address: _______________________________ Fax: ___________________
City: __________________________________ E-mail: __________________
State: ______ Zip: _________

Please select payment method:
 VISA / Mastercard/ American Express / Discover (please circle)
Credit Card #: __________________________________________
Expiration Date:_________
Security Code (required for monthly giving):_________
Signature: ____________________________________________

Become a Monthly Donor
Help TPL build our cash reserves so that we can act quickly and decisively to save threatened land that falls outside of our established budget or plans. Monthly giving is easy and convenient with an automatic payment of your choice deducted from your credit or debit card.

______ Yes, I want to make a monthly contributions of $_____ per month. Please charge my credit/debit card listed above. I understand that I can change or cancel my pledge at any time.

* Join the Mary and Wallace Stegner Society
When you make a gift of $1,000 or more you are welcomed into the Mary and Wallace Stegner Society, a group of TPL's closest friends who provide the critical support we need to protect America's precious landscapes for future generations.

Memorial or Honorary Gift
I'd like to make this gift

In memory of ______________________________

In honor of ________________________________

Please send acknowledgement of my gift via mail or email (circle one):

Name: _______________________Address: ______________________________
City:_____________________ State: ______ Zip: ________
Email address:_____________________________

The amount of my gift is not mentioned in the acknowledgment letter.
___________________________________

All gifts to TPL are tax-deductible to the fullest extent of the law.

For questions or information, please contact us at 1-800-714-LAND or by email