Beyond AIDS Foundation – Supporter & Donation Form

Please complete the supporter information below. You may submit with or without making a donation.

Beyond AIDS Foundation Supporter Information for Submitting Donations

The information you supply will allow us to list you with correct Contact Us in our database and email list. Please fill out the form below and then click “SUBMIT AND PAY” for online submission and payment. This should take you a PayPal page to submit secure payment to Beyond AIDS Foundation by credit card or PayPal account.

You may alternatively click here for a printable copy to complete manually and submit by mail with your check(s) to Beyond AIDS Foundation.

If you use the hardcopy submission method, checks to Beyond AIDS Foundation for tax-deductible donations should be made out to Beyond AIDS Foundation and mailed to 1275 W. Park Ave. #7718, Redlands, CA 92373. They save us Paypal fees and enhance the value of your payment.

Please Complete The Form Below
Date*
First Name and Middle Intial*
Last Name*
Title/Degree/Other Person
Street*
Apt/Suite
City*
State/Country*
Zip Code*
Please indicate whether this preferred address is:
Residence
Work
Preferred Email*
Alternate Email
Work Phone
Home Phone
Mobile Phone
Fax Number
Please indicate whether the preferred phone number is:
Work
Residence
Mobile
Profession and Employer
Academic or Organizational Affiliations:
Areas of Special Interest: (Please check all that apply.)
(Note: The Foundation is kept solvent through generous large donations, but donations of any amount are appreciated and qualify the donor as a supporter.)
Exempt Option: You have the choice to make a voluntary donation if you wish.
Please Indicate Your Donation Amount $
After submitting the form, you will be redirected to the Beyond AIDS Foundation Paypal page. Enter the amount of your donation in the "Donation" box.

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