Print out this form,  Fill it out and mail it with your check to:

Sportsmens Land Trust, Ltd
630 Silver Street
Agawam, MA  01001

Select One:

___  Regular Member  -  $50.00

___  Sponsor    -  $100.00

___  Charter Lifetime Member  -  $2,000.00

Name:                                                                                                

Address:                                                                                             

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Email Address (optional)