Family & Youth Services Bureau A Gift to Porter County's Youth

Please accept my enclosed gift of $ to the FYSB.
Please accept my pledge of $ to the FYSB.
Please send reminders as specified
This is a personal donation.This is a corporate donation.

Name(s)
(as you would like it to appear in printed materials)

Company Name (if applicable

Address

City/State/Zip

Telephone (home) (work)

Donation in memory/honor of (Name)

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I have enclosed a check for $ (Please make payable to FYSB)

Signature _______________________________________________________________

Thank you for your generosity!
Family & Youth Services Bureau
253 W. Lincolnway
Valparaiso, IN 46383
219-464-9582
Fax: 219-462-4195
www.fysb.org

Family & Youth Services Bureau
Receipt for donation
Amount $
Date
All gifts are tax deductible in the extent that no goods or services are provided in return.
FYSB is:
a 501(d) (3) tax exempt organization
a United Way of Porter County member agency
an "affiliate fund" of the Porter County Community Fondation