WUSB Donor Registration Form
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Email *
First name *
Last name *
Street address *
City *
State *
Zip Code *
Phone Number (include area code) *
How would you like to make gift donation? *
Would you like a thank you premium gift? *
RECURRING AND 90.1 and 107.30 PACKAGE CHOICES If you selected "Yes, please!" above, please choose premium:
SINGLE ITEMS CHOICES If you selected "Yes, please!" above, please choose premium:
TSHIRT SIZE If you selected a premium that includes a sized clothing item, please check off size (write any special requests in comments box below.)
SWEATSHIRT SIZE If you selected a premium that includes a sized clothing item, please check off size (write any special requests in comments box below.)
For "Recurring Monthly Pledge" please confirm by writing in the MONTHLY dollar amount you wish to pledge.
TOTAL dollar amount donated for pledge. *
If you are committing to a recurring monthly pledge, please multiple your monthly dollar amount by 12 (months) and indicate in the space provided below. If this is a one-time pledge please indicate that total in the space provided below.
Please share any further information you'd like us to know, any comments or questions, or indicate the show you are pledging for in the space below. And Thank you from all of the WUSB Staff !
A copy of your responses will be emailed to the address you provided.
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