WRIR-LP 97.3 FM · Fund Drive Donation CREDIT CARD

$

2) Specify Monthly or One Time

3) Select Size

A minimum gift of $10 a month or $60 one time

I would like to

Station is open from 9a-9p during the fund drive. 1621 W. Broad Street 2nd floor.

Pick up my shirt

Mail my shirt & add $5 to cover shipping (WRIR will charge separately)

Mail my shirt w/o the additional cost of shipping

Name

First Name

Last Name

Email

Phone

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Tell Us About Yourself

This is my first time donating!

I'd like info on volunteering

I'd like a tour of the station

What are your favorite shows?

For Office Use Only

Check if you are the WRIR volunteer sitting in the office completing the form. Otherwise, continue to pay.

Yes, I am the WRIR volunteer

Your Name (WRIR volunteer taking the donation)

Donor Paid

Wufoo Volunteer

Questions, comments, issues with this donation

Power WRIR-LP 97.3 FM!