Pledge Form for Phil's Walk of the AT Trail Survey

1.Please choose your pledge level:(Required.)

Tick - 1 Penny per mile for a total of $21.75

Mouse - 2 Pennies per mile for a total of $43.50

Pony - 3 Pennies per mile for a total of $65.25

Deer - Nickel per mile for a total of $108.75

Snake - Dime per mile for a total of $217.50

Hawk - Quarter per mile for a total of $543.75

Wild Hog -Half Dollar per miles for a total of $1,087.50

Bear - One Dollar per mile for a total of $2,175.00

2.By adding my contact information below, I pledge the above donation to Phil's Walk of the AT Trail. I understand that this pledge amount may change if Phil does not complete the entire walk of the AT Trail. I give permission for CCAR to invoice me based on the total amount of miles walked. (Required.)

Name:

Address:

Address 2:

City/Town:

State:

ZIP:

Email Address:

Phone Number:

3.I would like to receive updates about Phil's progress.

Yes

No

4.Did a CCAR Staff Person refer you to this form? Please tell us who...

Pledge Form for Phil's Walk of the AT Trail

You can Partner with Phil!