Please fill out form below and send payment of $200. You can pay online on the Donate Now! page. If mailing a check, please include this form with your check. The requesting party will be notified after the plaque is placed on the wall.
Mail To: Crystal Lakes Community Fund Association
PO Box 557, Red Feather Lakes, CO 80545
DISCLAIMER: The engraving on the plaque will be exactly as written in this form. See RULES & REGULATIONS listed below.
PO Box 557, Red Feather Lakes, CO 80545
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To be completed by the Community Fund representative. This form will become a permanent record in the Crystal Lakes Community Fund files.
Date form completed:__________________
Date form received:____________________
Date plaque placed on wall:______________
Plaque Fee $100.00 - Paid: ________________
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