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2. Full Name
4. Email
6. Phone Number
8. Address1
10. Address2
12. City
13. State
14. Zip
18. Donation Type

    1. Monetary
    2. Volunteer Time
19. 
23. Monetary Donation*

    If you selected monetary donation, please choose your donation amount below, or enter a custom amount. Every bit helps us maintain and improve the trail for everyone to enjoy.

    1. $20
    2. $40
    3. $50
    4. $60
    5. $85
    6. $100
    7. $150
    8. $200
    9. Other Amount
25. Other donation amount:
27. Payment Type*

    1. Check
    2. Cash
    3. Credit/Debit Card
29. Payment Instructions

    If you wish to mail a check, please send it to: 
    Delta County
    Attention: Leone Anderson/Miners Trail
    560 Dodge Street
    Delta, Colorado 81416

    Cash:
    Please bring to the Administration Office at 560 Dodge Street in Delta and can be left in an envelope addressed to Leone Anderson for The Miners Trail. 

    You can also use a credit card or debit card. Just follow these instructions.

    
    

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30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

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