I, __________________________________________________________________________________
	                                                                                 (name of donor)

of _________________________________________________________________________________
                                                                                           (address)

for value recieved, and in consideration of the subscription of others, hereby subscribe and promise to pay the 
Maxwell Conservation trust, Ltd. (Federal Tax ID #04-3425747) 

the sum of __________________________________________________________________________  
                                                                              (please write out amount)

($_______________) to assist said Maxwell Conservation Trust in the purchase of a lot of land on 
Collier Road, known in the town assessors book as 64-6-7, on Third Cliff in Scituate, Massachusetts.

This Pledge must be paid by February 1, 2002 as follows:

___________________________________________________________________________________

___________________________________________________________________________________
                                                                   (please write out how and when you plan to make payment(s))

I hereby acknowledge that in reliance on this pledge, Maxwell Conservation Trust may elect to enter
into a contract or contracts with the owners for the purchase of said property.

EXECUTED as a sealed instrument this __________ day of _____________________, 2001.


_________________________________________            _____________________________________  
Signature                                                                                                     Printed Name


___ I wish my gift to remain anonymous

___ My gift may be made public (amounts are always confidential)