Text Message Service Permission – YES to the Future

The Central Susquehanna Intermediate Unit (CSIU) Community Education, Training and
Workforce Services uses a text message service* as a way to keep you informed and
help you and your family succeed. We will send you messages about important deadlines
and assignments, CSIU program closings and delays, valuable community services, and
information that will support you and your family.

You can opt-out of text messages any time – reply STOP to any text message.

I agree to receive text messages from the YES to the Future program. I understand
that participation is voluntary and I can stop participating at any time. I understand
that enrollment will not affect my participation in YES to the Future in any way, now
or if I change my mind later.

Cell Phone Number to Receive Text Messages*
County you Live in*
YES Career Counselor*
Date of Birth*
MM slash DD slash YYYY
Signature of Participant*
Date*
MM slash DD slash YYYY
Name of Participant*
First Last

* Text Message & Data Charges may apply from your cell phone service carrier. The CSIU is
not responsible for any charges that may result from use of this service.
Your privacy is important – your information will not be sold or provided to third parties.
If you have questions please contact Katherine Vastine at kvastine@csiu.org or
570-556-8446.