Thank you for supporting me as I participate in
2025 SoCal Ride, Walk & Roll to Cure ALS
Team Name: ALS Network Staff - SoCal Ride
Step 1. Billing Information
First Name: Last Name:
Address:
City: State: Zip:
Phone: Email:
Address is different than one on check. Please use above address.
Step 2. Select Donation Details
$500 $250 $100 $50 $25 Other $
Cash
Check # , made payable to: ALS Network
Credit card #: exp: /
Signature:
Signature:
Name for Donor Honor Roll Recognition (ex: The Smith Family or Aunt
Sue):
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: 2025 SoCal Ride, Walk & Roll to Cure ALS
PO Box 7082
Woodland Hills, CA 91365
For Office Use Only:
Check # Cash $
Received by Entered in LO
by
If you have questions or to donate by phone, please call (818)-865-8067. | alsnetwork.org
ALS Network