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YES, I WANT TO SUPPORT THE YOUTH SERVICE BUREAU.

Fill out this form, print and mail with your contribution to:
Youth Service Bureau
244 North Lake Street
Forest Lake, MN 55025

I/we wish to contribute:
$50 $100 $250 Sponsor a Youth ($325) $500
100 Donor - $1,000 Plus Club ($1,000) Other_____

Name:

Street Address:

City, State, Zip Code

E-Mail Address:

Daytime Telephone

I wish to remain anonymous

I/we wish to designate the donation to:
Area needed most Diversion/Restorative Justice Youth & Family Counseling
Elementary Program Prevention Services High Risk Services
Youth Leadership Programs for Girls Summer Programs

Many companies have matching gift programs that will double your contribution. Check with your company's Benefits Manager or Human Resources Office.

THANK YOU!!!

Your gift will provide needed services to local youth and families. Your gift in any amount can change someone's life!

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