AIDS Walk Memorial Project

You can honor those who lost their fight to AIDS and help continue our mission of education and prevention. Your donation of $55 will place the name of your loved one (or you can "adopt" a name) on the Walker T-Shirt, as well as a banner that families carry at the beginning of the Walk.  The Memorial Project also participates in a city-wide multi-faith service honoring those who have lost their battle on World AIDS Day, December 1st. Watch this video for more information about the AIDS Walk Kansas City Memorial Program.
http://www.youtube.com/watch?v=bxOoRnpHhEU

Honor your Loved One in 2011

To continue our fight against AIDS with prevention & care, we ask for a yearly donation of $55 to honor your loved one’s name on the walker’s shirts. A banner will be created for you to carry at the beginning of the walk, or you can ask for a volunteer to carry it for you.

* Required

1. In honor of

Name:

2. Your Information

Shirt Size
-- Please select -- Small Medium Large X Large XX Large XXX Large

First Name *

Last Name *

Email Address *

3. Shipping

Shipping Address *

City *

State *

Zipcode/Postcode *

Country *
-- Select Country -- UNITED STATES

4. Billing

Billing Address * Same as Shipping

City *

State *

Zipcode/Postcode *

Country *
-- Select Country -- UNITED STATES UNITED STATES MINOR OUTLYING ISLANDS

5. Payment Information

Name on Card *

Card Number *

Card Expiry *
01 02 03 04 05 06 07 08 09 10 11 12 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Card Type *
Visa Master Card American Express

CCV Number *

Amount *