becoming a KTXT member

KTXT-TV MEMBERSHIP FORM
FESTIVAL PHONE: 741-7015 1-800-530-4735

You can become a loyal contributor and essential part of the fund-raising
success of KTXT-TV. As a member of KTXT-TV, you acknowledge being
the "public" in the Public Broadcasting Service.

Be More--Watch and Support Your Public Television!

Please reply by responding to the following form or print the form with your information included and send it to the address below. If you have any
questions, contact Tim Chambers or Pat Dyke, Membership Coordinator at
806 742-2209. Thank you for your continued support or new support of
KTXT-TV Channel 5, South Plains Public Television. Your contribution,
no matter what level, makes a difference.

Tim Chambers
Manager of TV Development
KTXT-TV. Texas Tech University
Box 42161
Lubbock, TX 79409-2161

YES! I want to support fine PBS broadcasting on the South Plains!

Which amount would you like to donate? All memberships $35.00 and above
include a KTXT-TV Guide delivered through U.S. mail.

Let me check out all thank you gifts!

$35.00 basic membership (includes mailed guide)

$60.00 membership: $70.00 membership; $75.00 membership; $80.00 membership

Let me check out all thank you gifts!: $90.00 membership
: $100.00 membership
: $120.00 membership
: $125.00 membership

Let me check out all thank you gifts!; $150.00 membership; $165.00 membership; $175.00 membership

Let me check out all thank you gifts!

$180.00 membership

$200.00 membership

$225.00 membership

Let me check out all thank you gifts!

$240.00 membership

$250.00 membership

$300.00 membership

Let me check out all thank you gifts!

$350.00 membership

$360.00 membership

$500.00 membership

$1,000 membership

Let me check out all thank you gifts!

Amount of contribution different from above:

Tell us how to get in touch with you:

Name/Org./Business
E-mail
Address
City/zip
Telephone
FAX

I want to: (click as many as apply)

Pay by check, send me an invoice

My company will match my gift, I will send in the company form

Pay by credit card, send me an invoice with credit card information.

Please bill me: (check one--only pledges of $60.00 and above can be billed in payments)

One Payment Two Payments Four Payments Monthly

Please contact me as soon as possible regarding this matter.

FESTIVAL PHONE: 741-7015 1-800-530-4735

Please enter any general comments, concerns, questions or suggestions in the following
space. This is not a secure site; please do not enter credit card information. We will send
you an invoice and a form for credit card information. If your company matches your
contribution, please contact your personnel department and list your company below.

KTXT-TV Copyright � 1999. All rights reserved. Revised: July 03, 2003.

KTXT-TV
Copyright � 1999. All rights reserved.
Revised: July 03, 2003.