Give to Partner with Youth

Partner with Youth campaign and make an impact on youth in our community with a $_____________ gift.

2009 Partner with Youth Brochure

Yes, I/ we want to support the

Name: (As you wish it to appear for recognition purposes)

Organization:

Address:

City State Zip:

Phone #: Home Other #

E mail address:

PAYMENT METHOD:

_ My check payable to the YMCA Partner with Youth Campaign is enclosed.

OR

_ Amount enclosed $________________ Balance Due $__________ _ Please bill me for the remainder as follows: _ Quarterly(June, Sept, Dec)

_ End of year (December)

OR

_ Please charge my credit card for my total pledge amount: _ Visa _ MC _ Discover

Card # ___________________________________ Exp._________ 3 digit verification code:__________ Signature:__________________________________

OR

_ I would like to pay using the YMCA bank draft system. Payments are charged to your account on the 20th of each month.

Please charge my account $______________per month for ____ months. For this option, please provide a copy of a voided check.

_ I wish to remain anonymous

_ My gift will be matched by_________________________________________________

_ I am interested in speaking with someone about how I can include the YMCA in my estate plans.

PLEASE DESIGNATE MY GIFT TO:

_ North Area Family YMCA _ East Area Family YMCA _ Downtown Family YMCA

_ Y – Arts Branch _ YMCA Day Camp Iroquois _ General Campaign (includes all branches)