Family Size 1 SAN ANTONIO URBAN MINISTRIES MONTH_________________YEAR_______ AFTER SCHOOL KARE PAYMENT COUPON

_________________________________________________ _______________________

CHILD’S NAME ACCOUNT #

_______________________________ __________________________________________________

PARENT’S NAME STREET ADDRESS

MAIL PAYMENT TO: AMOUNT DUE: $187.00

AMOUNT DUE AFTER THE 5^TH $207.00

SAN ANTONIO URBAN MINISTRIES

AFTER SCHOOL KARE AMOUNT ENCLOSED: ______________

PO BOX 17469

SAN ANTONIO, TX 78217 CHECK NUMBER: ______________

YOUR CANCELLED CHECK IS YOUR RECEIPT

Family Size 1 SAN ANTONIO URBAN MINISTRIES MONTH_________________YEAR_______ AFTER SCHOOL KARE PAYMENT COUPON

_________________________________________________ _______________________

CHILD’S NAME ACCOUNT #

_______________________________ __________________________________________________

PARENT’S NAME STREET ADDRESS

MAIL PAYMENT TO: AMOUNT DUE: $187.00

AMOUNT DUE AFTER THE 5^TH $207.00

SAN ANTONIO URBAN MINISTRIES

AFTER SCHOOL KARE AMOUNT ENCLOSED: ______________

PO BOX 17469

SAN ANTONIO, TX 78217 CHECK NUMBER: ______________

YOUR CANCELLED CHECK IS YOUR RECEIPT