This form is provided to assist you in contributing towards the American Freedom Ride, The Great Teddy Bear Hug, and/or the American Freedom Ride Scholarship Fund.  Please fill out the form below and someone from our office will get back to you as soon as possible.  Please complete the form below and let us know how you intend to be involved.

What kind of notification would you like to send to the Freedom Ride organizers?      

A pledge for Scholarship Fund (tax-deductible donation to A.H.E.F.)                                          

A pledge for Rider Support (non-deductible donation to provide for riders lodging, food, or fuel)  

A promise to appear on the ride route with teddy bears from our community's children                 

Other                                                                                                                                         

At what itinerary stop should we look for you?

Rally Stop Location San Diego, CA Escondido, CA Riverside, CA Las Vegas, NV Kingman, AZ Flagstaff, AZ Phoenix, AZ Tucson, AZ Los Cruces, NM San Antonio, TX Houston, TX Dallas, TX Oklahoma City, OK Fort Smith, AR Little Rock, AR Memphis, TN Nashville, TN Knoxville, TN Lexington, KY Cincinatti, OH Indianapolis, IN Milwaukee, WI Chicago, IL Kalamazoo, MI Detroit, MI Toledo, OH Columbus, OH Pittsburg, PA Charleston, WA Charolettesville, VA Richmond, VA Alexandria, VA Washington, DC Baltimore, MD Philadelphia, PA Trenton, NJ Albany, NY Boston, MA Providence, RI New London, CT New Haven, CT Bridgeport, CT Stamford, CT New York, NY City not along the itinerary Call me, I would like to help plan a rally Call me, I would like to host an event (Other) Other:

Enter the specific details of your pledge or promise in the space provided below:

Tell us how to get in touch with you:

Name
Address
City
State, Zip
E-mail
Telephone (day)
Telephone (night)

Please contact me as soon as possible regarding this matter.