WUSB Donor Registration Form
* Required
Email address
*
Your email
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
How would you like to make gift donation?
*
Recurring monthly credit card pledge of $5 or more per month.Use secure credit card link after submitting at end of form
One-time credit card pledge. Use secure credit card link after submitting at end of form
Email me an invoice
Post mail me an invoice
Would you like a thank you premium gift?
*
No thank you keep up the great radio!
Yes please! Choose below and write in the comments box below.
If you selected "Yes, please!" above, please choose premium:
Monthly Recurring Pledge Package (premium offered corresponds with annual pledge total)
$90.10 Package (t-shirt and baseball cap-- write-in size below)
$107.30 Package (t-shirt, sweatshirt and baseball cap-- write-in sizes below)
$75.00 (sweatshirt-- write in size below)
$50.00 (t-shirt-- write-in size below)
$35.00 (baseball cap)
$35.00 (tote bag)
$35.00 (WUSB mask)
$35.00 (WUSB mug)
$15.00 (CD-- write-in favorite music genre in comments)
Other:
If you selected a premium that includes a sized clothing item, please write in size(S) required.
Your answer
For "Recurring Monthly Pledge" please write in MONTHLY dollar amount you wish to pledge.
Your answer
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.
Your answer
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.
Your answer
Submit
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