Valley Youth House - Online Donation Form

Yes...I would like to help Valley Youth House provide shelter, counseling, prevention and developmental recreation services to troubled young people and their families.

Please earmark my donation toward the following (choose one or more categories):

Annual Appeal:
Capital Campaign:
General Donation:	Specify Program

* Name:
* Address:

* City:
* State:
* Zip:
* Phone:
* Email:

* Credit Card:
* Card #:
* Security Code:	What is this?
* Expiration Date:	Month: Year:
* Name on Card:
Amount:	$0.00


* Denotes required field

If donating by check, please print this form and mail or fax it to the address or number shown below:

Please mail this completed form to:
Valley Youth House
Development Office
829 Linden St.
Allentown, PA 18101

Or fax this completed form to:
610-820-5907
Attn: Jeff McCausland, Development Office

If you have any questions, please call Jeff McCausland, Development Office at 610-820-0166

Thank you for supporting Valley Youth House and our mission to provide shelter, counseling, prevention, life skills, and developmental recreation services to local children, youth, and families.