Avenidas World AIDS Day

World AIDS Day

World AIDS Day is a day to remember, to honor, and to be educated. Avenidas Rainbow Collective invites you to do just that.

Please fill out the form below so that we may send you a beautiful AIDS Ribbon Pin in the mail as well as the Zoom link via email.

Thank you in advance for your participation.

Avenidas Rainbow Collective

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* 1. What is your name?

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* 2. What is your Address?

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* 3. What is your Email Address?

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* 4. Do you identify as a member of the LGBTQ Community?

Yes

No

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* 5. What is your age range?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 6. Have you lost a loved one to HIV/AIDS? if so, please share their name and their relationship to you so that during the moment of silence we may include his name our list of those we remember. (ex. Theodore Kingery; Father)

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* 7. If you would like to include a photo of your loved one that we can show on the screen at the event during the moment of silence please upload here.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* 8. Do you have any specific questions or concerns about HIV/AIDS that you would like answered during the event?