general membership

KTXT-TV MEMBERSHIP FORM

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.

If PBS doesn't do it--who will? And we can't do it without your help!

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 $25.00 and above include a KTXT-TV Guide delivered through U.S. mail.

$25.00 basic membership

$50.00 membership

$120.00 membership

$140.00 membership

$170.00 membership )

$250.00 membership

$300.00 membership

$500.00 membership

$1,000 membership

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.

KTXT-TV Copyright � 1999. All rights reserved. Revised: April 10, 2001.

KTXT-TV
Copyright � 1999. All rights reserved.
Revised: April 10, 2001.