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DONATION FORM

First Name
Last Name
Street Address
Apartment Number
City
State
Zip Code
E-mail address
Home Telephone: (555-555-1234)
 
Amount Quantity Subtotal
$25.00
$50.00
$75.00
$100.00
$150.00
$200.00
 
Total:
Other Amount

Please check method of payment

 

Check
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Thank You for your Donation!

If you would prefer to contribute by mail, please send a check to: Youth Shelter Program of Westchester, Inc.                                   220 East Eighth Street                                                               Mount Vernon, NY 10550

The Youth Shelter Program of Westchester, Inc., is a 501(c)(3) organization under the federal Internal Revenue Code. A copy of our annual report is available by writing to the New York State Office of Charities Registration, Albany, NY 12231. If your employer has a matching gifts policy, please send us the appropriate form.

 


“The Youth Shelter Program is a better place for me…it's a place where you could get your mind right, change your behaviors and learn better coping skills to make tough decisions. And it all benefits you.”

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