HIV Testing Campaign Donation Form

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Thank you for your generous contribution to the Pedro Zamora Memorial Fund. We are extremely grateful to you for your special effort to honor the memory of Pedro and to continue his work in AIDS advocacy.

Your donation helps fund the work of the Pedro Zamora Fellowship Program. The fellow's experience at AIDS Action empowers them to be spokespeople in their own communities to halt the spread of AIDS. Your contribution is allowing AIDS Action to continue Pedro's HIV prevention and education work.

First & Last Name:
Email:
Phone:
Address:
City: State: Zip Code:
Amount: $
MC/Visa, AMEX Number: - - - Exp. Date:

I hereby authorize AIDS Action to process 
the above donation. A record of payment
will be included on my credit card
statement and will serve as my receipt.


AIDS Action

1906 Sunderland Place NW

Washington, DC 20036

Phone: (202) 530-8030
Fax: (202) 530-8031
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