Submission Form

Ride With Pride Submission Form

Name:                                                 Club (optional)                                                     .

Address:                                                                                                                            .

                                                                                                                                            .

Bike Make/Model                                                                                                             .

Start Date                                    Odometer Reading                .

End Date                                     Odometer Reading                .

                                                      Number of Miles                    .

Special Notes (please limit to 100 words or less)

                                                                                                                                            .

                                                                                                                                            .

                                                                                                                                            .

Authorized to publish on BikersForOurTroops web site

Yes ____ No ____  Signed:_________________________Date                          .

BikersForOurTroops will not sell or distribute this information. Other parties will gain access to this information if it is published on our web site. Donations to BikersForOurTroops are tax deductible. Receipts will be issued for all donations of $250 or more directly by the National Heritage Foundation. BikersForOurTroops will acknowledge all donations. All checks should be made payable to BikersForOurTroops. Please do not send cash. Please mail your completed form and check to:

BikersForOurTroops

185 Miller Rd., Cookeville, TN 38501 

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Copyright © 2005 BikersForOurTroops
Last modified: 01/24/06