90.9 FM - KTSU - Houston

Are you a:

Renewing Member New Member

May we read your name on air?

Yes No

Name

Address

Suite/Apt #

City

State

Zip

Home Phone

Business Phone

INDIVIDUAL MEMBERSHIP LEVELS

DONATION AMOUNT OTHER THAN A MEMBERSHIP LEVEL

$20.00

(Students Only) KEY RING

Schoolname :

$45.00

(select one) Gospel Jazz Blues Oldies

$65.00

(select two) Gospel Jazz Blues Oldies

$100.00

KTSU T-SHIRT(PLEASE INDICATE SHIRT SIZE)

M L XL XXL XXXL

$150.00

4-CD SET (select one)

Gospel Jazz Blues Oldies

$250.00

KTSU TOILETRIES BAG (2 cd's (select one)

Gospel Jazz Blues Oldies

$365.00

KTSU LAPTOP CARRYING CASE

$500.00

KTSU OPTICAL WIRELESS MOUSE & KTSU LAPTOP CARRYING CASE

$1000.00

CHOICE BUILDERS

NO GIFTS PLEASE, I WOULD LIKE ALL OF MY PLEDGE TO SUPPORT PROGRAMMING

SPECIAL PREMIUM

NOTE: (ANY QUESTIONS REGARDING SPOTS SHOULD BE DIRECTED TO THE DEVELOPMENT STAFF)

BUSINESS/CHURCH/UNDERWRITING

Spring 2008 Special Underwriting Packages

$1,500.00 Underwriting PKG	$3,000.00 Underwriting PKG
BUSINESS/CHURCH NAME :

CREDIT CARD INFORMATION

Type of Credit Card

Visa MasterCard Discover

Card Holder

Creditcard number

Expiration Date

MAKE CHECK PAYABLE AND MAIL TO:

KTSU - 3100 CLEBURNE STREET - HOUSTON TX - 77004