WUSB Donor Registration Form
* Required
First name
*
Your answer
Last name
*
Your answer
Street address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Phone Number (include area code)
*
Your answer
Email Address
*
Your answer
Amount donated
*
Your answer
Would you like a thank you premium gift?
*
No thank you keep up the great radio!
Yes please! I will write my 1st choice in the comments box below.
Please write in your premium gift selection from the list on pledge form included on front page of our website!
Your answer
Please write in your name, any comments, the show you are pledging for (if there is one) and any additional information we need to know!
*
Your answer
How would you like to make your gift donation?
*
Mail me an invoice please!
Recurring monthly credit card pledge of $5 or more per month.Someone will call you to confirm this pledge.
One-time credit card pledge - Please use submit button below then go to our website front page to use secure credit card link to donate.
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