Youth With A Mission Mail-in Contribution Form
Enclosed, please find my check, made payable to
Youth With A Mission

in the amount of $__________,

designated for:
   __ Hurricane Katrina Disaster Relief
   __ Living Alternatives
   __ Where needed most

     
Name: ________________________________________

Street Address: _________________________________

City: __________________________________________

State: _________
 
Zip: ____________
     
Daytime phone: _____________ Evening phone: _____________
 
Mail this form and check to:

Youth With A Mission
P.O. Box 6787
New Orleans, LA  70174
 
 

 

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