Date: |
Colorado Springs Utilities will send a confirmation letter within 10 business days. At the end of the year, we will send you a letter stating the amount of your annual donation.
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*Name (on the utility bill):
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| *Address: | |
| *City: | |
| *State: | |
| *Zip: | |
| *Home Phone: | |
| *E-mail Address: | |
Colorado Springs Utilities Account Number:
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*I am requesting to make a contribution of: $5
$10
$15
$20
Other: $ |
*I would like to make: One-time contribution (selected from above)
Monthly contribution (please bill the above amount monthly to my utility bill) |
