Sustaining Membership Information
Please select your new monthly gift level. Your new amount will replace your existing monthly amount.
Amount:
$ 5.00
$ 10.00
$ 15.00
$ 20.00
Or Your Preferred Monthly Amount:
$
*
Additional Information
Sustaining
Membership
Frequency
Day 8 of every month
Starting:
Ending:
Who do you support KING FM?
2013 Thank You Gift:
Use My Gift for Drive Challenge Fund:
Yes
No
Contact Information
Title:
Mr.
Ms.
Mrs.
Dr.
Miss
Master
Prof.
The Honorable
Judge
Rabbi
Reverend
Sister
Father
Brother
Lt.
Capt.
Major
Cmdr.
Col.
Admiral
General
Ambassador
Senator
Governor
Sir
Madam
Sir/Madam
Drs.
Dewalt
Mr
B.
F.
LT. COL.
First name:
*
Last name:
*
Country:
Andorra
Australia
Bahamas
Belgium
Bolivia
Brazil
Canada
Chile
Colombia
Denmark
Egypt
Finland
France
Germany
Greece
Grenada
Hong Kong
Israel
Italy
Japan
Jordan
Kenya
Korea
Kuwait
Malaysia
Mexico
Netherlands
New Zealand
Panama
Phillipines
Poland
Puerto Rico
Saudi Arabia
South Africa
Spain
Switzerland
Taiwan
Thailand
Turkey
United Kingdom
United States
*
Address lines:
*
City:
*
State:
<Please Select>
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
CZ
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NP
NC
ND
NE
NL
NH
NJ
NM
NS
NT
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
NU
SP
*
ZIP:
*
Phone:
Email:
*
Payment Information
Payment Method:
Credit Card
Direct Debit
Cardholder's Name:
*
Credit Card Number:
*
Card Type:
Visa
American Express
Discover
MasterCard
*
Card Expiration:
01
02
03
04
05
06
07
08
09
10
11
12
/
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
*
Card Security Code:
*
Matching Gifts
My company will match my gift
Company:
*
© 2011 Classical 98.1