PLEDGE FORM
Please fill out this form and send a check to:
Ramiro Gonzalez
C/O Chicago AIDS Ride 5
1729 W. Melrose
Chicago, IL.
60657-1003

Please make the check payable to
Chicago AIDS Ride 5.
Once again, Thank you for your support.

First Name

Last Name

Street Address

City

State

Zip

Country

E-mail address

Amount of Pledge