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AIDS WALK ST. PETERSBURG
Sept. 13, 2008
REGISTRATION FOR AIDS WALK ST. PETERSBURG

Please Fill Out The Form Below to Register for the AIDS Walk. Common questions are answered in the "Quick Help" Sections to the right. DONT WANT TO REGISTER ONLINE? DOWNLOAD THE FORM TO PRINT OUT HERE
Account Information Quick Help
Username*(No Spaces, Case Sensitive) Remember your Username and Password are both CAsE SenSitiVe.
Password*(No Spaces, Case Sensitive)
Keep in mind your username will be part of your personal donation website that you can give to friends for them to sponsor you online to help meet your personal goal. Example http://www.AIDSWalkStPete.org/your-username
Personal Information Quick Help
First Name* Fields marked with * are required fields

Enter your 10 digit cell phone number and choose your cell phone carrier and you will recieve automatic updates when someone gives you a donation online. AIDS Walk St Petersburg will also send out periodic reminders via email and cell phone.

If you do not want to have text messages or emails sent to you, uncheck the respective boxes.

If you choose to have a public account, donors may search for your name to donate directly to your personal goal.
Last Name*
Address*
City*
State*
Zip Code*
Home Phone* (No Spaces, example 7275551212)
Cell Phone (No Spaces, example 7275551212)
Cell Carrier
Text AlertsReceive Text Message Alerts
E-Mail*
E-Mail AlertsReceive Email Updates
Public AccountPublic Username
Optional Information Quick Help
I can Volunteer to help with the event. Please contact me. Want to help with the walk? Check the box to the left!

If you raise $50 or more you will receive prizes, please choose your shirt size to help us plan what we will need.
Awards: If I qualify for a shirt, I want a:
Small Medium Large X-Large XX-Large I Decline all award Items.
Gender Female Male
Age 12 & Under 13-17 18-24 24-34 35-44 45-54 55+
Team and Company Information Quick Help
Team Name If you are part of a team, choose the team from the drop-down list at the left.

Does your company have a matching gift program? If so type the name of your company in the "Company Field"
Matching Gift?Yes No
Company Name









A COPY OF THE OFFICIAL REGISTRATION (#CH3696) AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THEDIVISION OF CONSUMER SERVICES BY
CALLING TOLL - FREE 1-800-435-7352 WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE
STATE. AIDS SERVICE ASSOCIATION OF PINELLAS, INC. DOES NOT ENGAGE PAID SOLICITORS SO 100% OF CONTRIBUTIONS GO TO SUPPORT ASAP.