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I understand my student s will be contacting me in December. Please return this form to Youthlinc office youthlinc.org Fax 801-467-1982 1140 E. Brickyard Rd. Name of designee Age Email of designee Please use additional sheet to indicate other designees. Any designated individual must meet Youthlinc application deadlines for the Service Year generally mid-October. Www. youthlinc.org /Donate/General Donation. Enter in Notes Sustaining Membership Pay in 84/month installments Please contact...

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