Name:____________________________________ Date:____________________
E Mail Address:_____________________________ Local Phone:______________
US Post Office Mailing Address:__________________________________________
____________________________________________________________________
YES, I want to support SPR with a tax deductible contribution.
Choose Your Membership Level and
Check One of the Three Below:
Tower Supporters ($1-$99)
Wavelength Boosters ($100-$249)
Antenna Angels ($250-more)
Amount Enclosed _____________
Are you a KBCO Listener? Yes or No _______
Are You Joining SPR because we rebroadcast KBCO Yes or No ______
The first 100 KBCO listeners who contribute $45 or more will receive
a free CD in the mail.
My Employer has a Matching Gift Program. Yes or No ____
Enclose Paperwork if Yes
Donate via PayPal
Please make check payable to: "Summit Public Radio"
Mail to P. O. Box 6392 Breckenridge, Colorado 80424
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WE ARE LISTENING TO YOU!
When you make your contribution please complete the membership form and return it with your check.
We will be using a web-base survey tool to send you an email link to our Listener Satisfaction
Survey; this process permits us to listen to you and guides our planning. We will email you an
invitation to our Annual Hike & Picnic and other SPR events. Only with your email address can
we implement these programs. Your membership includes "The Signal", our newsletter that
we will continue to mail to your postal address.
Your email address will be used for Summit Public Radio business only and will not be provided
to any other organization without your consent.
_________________________________________________________________________
Thank you for your contributions and opinions.
We could not do it without you!
