Tuesday, 30 Nov 2021


Florida AIDS Action depends on the community to support its vital work. To continue to address the many complexities of the HIV/AIDS epidemic and related health care issues, your assistance is essential. You can make a contribution to Florida AIDS Action by completing the information below. Your active involvement in our work is crucial. Florida AIDS Action is a 501(c)(3) nonprofit charity as defined by the Internal Revenue Service. Your contribution is tax deductible.

Name: ______________________________________________________
Address: ____________________________________________________
City: ________________________________________________________
State and Zip: ________________________________________________
Day Phone: __________________________________________________
Evening Phone: ______________________________________________
Fax: _______________________________________________________
Email: ______________________________________________________

Your email address will be added to the Florida AIDS Action Broadcast. The Broadcast provides E-News and Alerts, special announcements, and updates. In addition, you will receive faxes and mail from Florida AIDS Action regarding upcoming events, public policy alerts, etc.

Contribution Amount

$25_____ $50_____ $100_____ $250_____ $500_____ $1,000_____ Other _____

Checks should be made payable to: Florida AIDS Action

Membership for organizations is available at various contribution levels and payment plans. Interested corporations and nonprofit agencies and associations should contact Florida AIDS Action at information@floridaaidsaction.org or (813) 232-5886.

Please print and return this form with payment to:

Florida AIDS Action
Administrative Center
P.O. Box 16705
Tampa, Florida 33687-6705

Thank you for your support.