2017 AYDC Membership Contribution Form
**Membership will be valid for the calendar year for 2017**
Contributing Member Benefits
The Anchorage Youth Development Coalition (AYDC) is a program of the Alaska Injury Prevention Center and
your AYDC membership contribution will directly support the AYDC program. Become a contributing member
of AYDC to directly support the services provided to Anchorage’s youth-serving community.
AYDC encourages you and/or your agency to make a meaningful contribution to our program. Please use this
table as a guide for suggested contribution levels, but please give what you can.
All AYDC contributing member agencies receive access to AYDC events, including Full Coalition meetings,
Brown Bag trainings, and other Professional Development opportunities. Additionally, each level includes the
additional benefits listed below:
Champion Circle
- Agency logo on the front page of our AYDC website and linked on e-newsletters
- Ability to be featured on AYDC materials
- Free 2-hour on-site training on positive youth development strategies and skills
- Free use of AYDC Conference Room (up to 3 times), including new SMARTboard and video conferencing
- Opportunity to showcase your agency and programs at Coalition meetings
- Your agency’s events and updates highlighted on our e-newsletters
- Agency listed and linked to on our AYDC website
- Eligible to apply for seat on the AYDC Leadership Team
Leadership Circle
- Ability to be featured on AYDC materials
- Free 2-hour on-site training on positive youth development strategies and skills
- Free use of AYDC Conference Room (up to 3 times), including new SMARTboard and video conferencing
- Opportunity to showcase your agency and programs at Coalition meetings
- Your agency’s events and updates highlighted on our e-newsletters
- Agency listed and linked to on our AYDC website
- Eligible to apply for seat on the AYDC Leadership Team
Director’s Circle
- Free 2-hour on-site training on positive youth development strategies and skills
- Free use of AYDC Conference Room (up to 2 times), including new SMARTboard and video conferencing
- Opportunity to showcase your agency and programs at Coalition meetings
- Your agency’s events and updates highlighted on our e-newsletters
- Agency listed and linked to on our AYDC website
- Eligible to apply for seat on the AYDC Leadership Team
Advocate’s Circle
- Free use of AYDC Conference Room (up to 2 times), including new SMARTboard and video conferencing
- Opportunity to showcase your agency and programs at Coalition meetings
- Your agency’s events and updates highlighted on our e-newsletters
- Agency listed and linked to on our AYDC website
- Eligible to apply for seat on the AYDC Leadership Team
Individual Membership
- Eligible to apply for seat on the AYDC Leadership Team
$3000+
$1500+
$500+
$250 +
$ 50 +
2017 AYDC Membership Contribution Form
Agency or Individual Information
Organization
Contact Person
Address
Contact Person Email Address
City, State, Zip Code
Website
Donation Level
Please state your one-time contribution for calendar year 2017 AYDC membership:
$___________
Method of Payment
□ Check Enclosed: make check payable to “Alaska Injury Prevention Center” with “AYDC” in memo line.
□ Please bill my credit card:
Card type (circle): Visa Master Card Discover American Express
Card Number
Expiration Date
CSC
Billing Address (if same as above, check here □)
Memberships are tax deductible. Your contribution will directly support the AYDC program, which is a
program of the Alaska Injury Prevention Center. Make checks payable to Alaska Injury Prevention Center with
“AYDC” on the memo line, and mail along with this form to:
Anchorage Youth Development Coalition
C/O Alaska Injury Prevention Center
4241 B Street, Suite 100
Anchorage, AK 99503
Alaska Injury Prevention Center
Tax ID 92-0169574