Donation Form
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The Preservation Trust was organized to assist the on-going effort to help save and protect the state's rich collection of historic architectural treasures.

To accomplish this critical goal, the Preservation Trust provides financial and technical assistance to communities and groups, undertakes educational programs, and accepts gifts of property.

Your contribution will be used to provide grants to save and protect Vermont's historic and cultural heritage.

Enclosed is my tax-deductible contribution

[ ] Contributor   $25
[ ] Supporter     $50
[ ] Sponsor     $100
[ ] Patron        $250
[ ] Founder's Circle $1,000
[ ] Founder's Circle $2,500
[ ] Founder's Circle $5,000
[ ] Founder's Circle $10,000

[ ] Other ___________________

[ ] Please add me to PTV's electronic newsletter list.

Name _______________________________________________________

Address _______________________________________________________

_______________________________________________________

Telephone ______________________________________________________

Email ______________________________________________________

PLEASE PRINT and MAIL THIS COMPLETED FORM TO: 
The Preservation Trust of Vermont
104 Church Street
Burlington, VT  05401