Name Submission Form

The Wall Las Memorias (TWLM) is dedicated to promoting wellness and preventing illness among communities of color affected by HIV/AIDS by using the inspiration of The Wall Las Memorias AIDS Monument as a catalyst for social change. We invite community members at large to submit the names of loved one's lost to AIDS or HIV complications. New names will be engraved onto the name panels on the monument and revealed during a special re-dedication ceremony to mark the unveiling of the renovated site. The names submission process is currently free of cost and open to community members from throughout the country. We also invite you to submit photos and videos of your loved one's along with your names submission form to info@twlmp.org. 

Applicant Full Name: