Youth Service Bureau Booster Club
Ensure the Success of Youth
244 N. Lake Street, Forest Lake, MN 55025
I WANT TO HELP YOUTH SERVICE BUREAU ENSURE THE SUCCESS OF YOUTH!
_____ I would like to become a $1000 Plus Club member: Donors of $1,000 or more support youth through our
programs and assist YSB in its effort to deliver quality services, improve and create new programs, and
track client outcomes to ensure needs are being addressed and goals are being achieved.
_____ I would like to renew my current $1000 Plus Club membership for another year.
_____ I would like to Sponsor-a-Youth: A contribution of $325.00 covers the average annual cost for one young
person to participate and complete YSB community justice, prevention, parenting and/or counseling
services. I would like to sponsor more than one youth and will donate $________.
_____ I would like to renew my current Sponsor-a-Youth commitment for another year.
_____ I would like to be a Friend of Youth: Each and every donation is important to continuing the work of the
_____I would like to make a donation of $__________ paid in full today. My check payable to Youth Service
Bureau is enclosed.
_____I would like to make a pledge of $_________ to be paid over _____ months. $_________ is enclosed today.
My pledge will be paid _____monthly _____quarterly _____semi-annually
(Please set up payment schedule and send me reminders.)
Credit Card payment
_____I would like to use my credit card to pay my pledge.
(Exactly as it appears on your credit card.)
Amount: _________________ Type of card:___Visa ___ Master Card ___ American Express
Card Number: Security Code: (3-4 digits)
Expiration Date: Month Year
I can volunteer or help in other ways!
_____ Please call me!
Name: __________________________________________ Phone Number: _______________
(Please print name exactly as you would like it to appear in our contacts with you.)
Address: _______________________________________ Email: ________________________
_______________________________________ Day Phone: ____________________
Thank you for helping YSB ensure the success of youth and families!