Send to the following address
Galloping Goose Historical Society of Dolores, Inc.
PO Box 297
Dolores, CO 81323

For additional Information
970-882-7082
Fax: 970-882-3243
Email:  gghs5@centurytel.net

Donation for Motor #5 Maintenance______________
Donation for Coach #256 Restoration_____________
Donation for RGS Lost Canyon Track Laying______
Donation for GGHS Operating Fund______________

Membership Application and Renewal

Name:_______________________________________

Address:_____________________________________

City:_________________State:___________________

Zip:__________PH#:___________________________

email address:_________________________________

$30.00   Individual Annual
$40.00   Family Annual
$50.00   Business Annual
$500.00   Life Sponsor
$1,000.00   Patron
$5000.00   Benefactor