ECO-TRACE AWARD FORM

ALDHA ECO-TRACE Award Form

First Name *

Last Name *

Trail Name

Email *

Phone 1

Address Line 1 *

Address Line 2

City *

State/Province *

Zip/Postal Code *

Country

Company Name

Submit as a company

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ECO-Trace Hike Type *

Thru hiking

Section Hiking

Day Hiking

One Trail Hiked

Multiple Trails

(Check all that apply)

ECO-Trace Hike(s) Start Date *

ECO-Trace Hike(s) End Date *

ECO-Trace Award Type *

ALDHA ECO-Trace Award Certificate & Patch

ECO-Trace Patch Rocker - 1,000 Miler

ECO-Trace Patch Rocker - 2,000 Miler

Name you want displayed on Certificate *

(check for typos, name will be printed as you have entered it!)

ECO-Trace Hike Details *

please give as much detail as possible regarding the dates, and specific trails on which you hiked that qualify for this recognition

ET Apply Date *

(Enter today's date. Thanks!)

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