Date: _______________________
Contact Name: __________________________________________________
Title: _________________________________________________________
Affiliation (as applicable): ___________________________________
Address: _______________________________________________________
Town, state, zip: ______________________________________________
Phone: _____________________________ Fax: _____________________
E-mail: ________________________________________________________
I am interested in volunteering on the Community Council. My interests are in:
|
water quality & quantity |
biodiversity & habitat |
|
land use & open space |
outreach & education |
|
stormwater |
development (fundraising) |
|
website |
conference planning |
Please check off your corporate giving category below:
Watershed Friend: up to $249
Watershed Patron: $250 to $499
Watershed Steward: $500 to $999
Watershed Benefactor: $1000 to $4999
Watershed Leader: $5000 and up
Or please check off your individual giving category below:
Watershed Friend: up to $25
Watershed Patron: $26 to $99
Watershed Steward: $100 to $249
Watershed Benefactor: $250 to $499
Watershed Leader: $500 and up
Please make your check out to the: "SuAsCo Watershed Community Council".
The Community Council is a 501c(3) organization pursuant to regulations of the Internal Revenue Service (IRS). All contributions are tax-deductible to the extent allowed by law.
Please mail this form to:
SuAsCo Watershed Community Council, Suite 200, 118 Great Road, Stow MA 01775.