Membership Form

NOTE: All fields marked with an * are required.

YES! I want to see permanently affordable housing in Clackamas County. I would like to join as a:
	Voting Member (Membership dues start at $10) Affiliate Member Organizational Member
First Name:*
Last Name:*
Address:*
City:*		State:*	Zip:*
Main Phone:*
Date:	mm/dd/yyyy
E-mail Address:*
Amount of Donation:	$10 $25 $50 $100 $250 (suggested nonprofit or group dues) $500 (suggested business dues) $1000 $1500 $Other
I would like to donate property or materials yes no
I would like information on partnering with CCLT yes no
Would you like more information on:
	Becoming a CCLT homeowner Becoming a CCLT volunteer Transferring property or other assets Informational session on CCLT at your workplace or organization
Employer:
Occupation:
How did you hear about Clackamas Community Land Trust?

Comments or Questions:

We'll mail you an invoice for payment; we do not yet accept payment over the Internet.

If you prefer, checks may be mailed. Print out this form and mail it with your check, made out to CCLT, to:
Clackamas Community Land Trust
11062 SE 21st Avenue Milwaukie, OR 97222
Phone: 503-659-1618

For more information call 503-659-1618