Save Mount Diablo’s Rise to the Challenge

Contribution Form
□ YES! I want to contribute to Save Mount Diablo’s Rise to the Challenge
                in honor of Your Name.

(Please select the appropriate contribution below)

_____ $20 I can’t believe you’re cycling to the top of Mount Diablo.
_____ $35 I know you can conquer the mountain.
_____ $50 Are you crazy? Mount Diablo is over 3,800 feet high.
_____ $100 Glad you’re riding – Not me!
_____ $250 Count me in to support you and Save Mount Diablo.
_____ $500 You owe me big time!
_____ $10,000 I’m looking for a big tax deduction.
_____ $ Other, _____________________

□ Please send me more information about Save Mount Diablo.

Please make your checks payable to "Save Mount Diablo" and mail it back to me.

Your Name
123 Your Street
Your City, State, Zipcode

Your contribution is 100% tax deductible to the full extent allowed by law.

Name___________________________________________________

Address_________________________________________________

City________________________________State_______Zip_______

Day Phone___________________ Eve Phone __________________

Email address____________________________________________

If you would like to charge your contribution to your credit card:
□ Visa □ Mastercard □ American Express

Card Number____________________________________________

Name on Card___________________________________________

Expiration Date________________________ 3-digit code_________

Signature_______________________________________________

Thank you for your generous donation!