Thank you for supporting me as I participate in
2024 SoCal Ride & Rally to Cure ALS

Participant Name: Andy Ragone
Participant ID: 1152010
Team Name: The Westlake Walkers

Step 1. Billing Information

First Name:   Last Name:  
Address:  
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Address is different than one on check. Please use above address.

Step 2. Select Donation Details

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Check #  , made payable to: ALS Network
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Yes, this is an honor or memorial gift in honor of:
 
Please provide the name and contact information for those who should be notified about your tribute gift (email or mailing address):
   

Step 3. Mail it in

Send this form with your donation to:
ALS Network
Attn: 2024 SoCal Ride & Rally to Cure ALS
PO Box 7082
Woodland Hills, CA 91365

For Office Use Only:

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If you have questions or to donate by phone, please call (818)-865-8067. | alsnetwork.org
ALS Network