Help Support South Whidbey Youth

Print this page, fill out the form and mail this with Your Gift Today!

Name  ______________________________________________

Address  ____________________________________________

City/State/Zip  _______________________________________

Phone  ________________  Email  _______________________

Credit Card (VISA __MC__ or ________)

Card Number________________________  Exp.____________

Authorized Signature  _________________________________

___ You may use my name in campaign materials      ___  I prefer to remain anonymous

Enclosed is my Gift of*: 

___ $50 (Guardian)

___ $100 (Friend)

___ $50/month

___ $100/month

___ $_______(other)

___ My employer will match my gift

___ Call me as a volunteer

 I would like my donation to support:

___ The Hub

___ Youth Leadership Council

___ What is Needed the Most

 *Contributions are tax deductible under IRS code 501(c) (3)

 Please mail this form with your check made payable to

South Whidbey Youth Connection

P.O. Box 331

Langley, WA 98260

Thanks So Much!