Senior Youth Group

Spring or Fall Clean up Day

For the Elderly

If you or someone you know needs help with clean up or other needs

Fill out the Application below & mail to:

Or drop off at Church

St John’s Lutheran Church Youth Group

11 North Queen Street

P.O. Box 97

Maytown Pa. 17550

Applications Due

Name___________________________________________

Address _________________________________________P.O. Box ____________

City____________________ Zip _____________ Township ______________________

Phone____________________ E-Mail _______________________

Please circle the cleanup chores listed below that you are in need of. Prioritize your needs by numbering them in descending order (#1 being your greatest need). Please understand that our goal is to meet as many of your needs as we possibly can, however due to limited time and resources, we may not meet all of your needs.

Deadline to submit application is

        ____ Leaf Raking                                      ____ Window Washing

        ____ Stick Pick-up                                    ____ Remove or Replace air conditioner

        ____ Lawn Mowing                                   ____ Remove – Replace Screens

        ____ Trimming / Weeding                         ____ Changing Smoke Detector Batteries

        ____ Clean Garden                                  ____ Others ( Please List)

        ____ Garage Clean up                              _______________________________

        ____ Till Garden                                       _______________________________