Donor Information
First Name
Last Name
Billing Address:
City:
State:
Zip:
Phone Number:
Email Address:
Donation Amount
I would like to make a donation in the amount of:
$1000
$500
$250
$120
$60
$35
Other Amount:
Please display my name on the participant's public donor wall as:
Please do not display my name on the donor wall.
Participant Information
Event Name2024 Pittsburgh Heart Walk
Event ID10693
Participant ID28503250
Participant NameOlivia Peterson
Team NamePittsburgh Chapter of the Links Inc.
Team ID
Mailing Information
Please send this completed form with checks to:American Heart Association | Attn: Pittsburgh Heart Walk | 444 Liberty Ave, Ste 1300 | Pittsburgh, PA 15222