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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!

What amount would you like to donate?

$35.00 basic membership
(includes printed guide through U.S. mail)
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)

Annually semi-annually quarterly  monthly

Please contact me as soon as possible regarding this matter.
 

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 or you may call Pat Dyke at 806 742-2209.

 



03/01/02
KTXT-TV
Copyright � 1999. All rights reserved.
Revised: March 01, 2002.
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