YES! I wish to support Milwaukee Public Television’s commitment to excellence with my level of annual membership indicated below:

LEADERSHIP CIRCLE

______ Platinum Patron $5,000

______ Gold Patron $2,500

______ Silver Patron $1,000

STUDIO CLUB

______ Studio Gold $500

______ Studio Silver $240

 

______ Enclosed is the total amount of my annual membership.

______ Enclosed is my first installment of my annual membership gift.

______ Please charge my credit card.

Account #______________________________________

___________ ____________________________

Expiration Date Signature

______ Please contact me about how I may donate gifts of stock, insurance or other assets.

______ Please contact me about including Milwaukee Public Television as a bequest in my will.

Name__________________________________________

Preferred Mailing Address__________________________________________

City/State/Zip__________________________________________

Day Phone/Evening Phone____________________________________

 

Please complete this form and fax or mail it to:

Channel 10/36 Friends, Inc.

700 West State Street

Foundation Hall, Fifth Floor

Milwaukee, WI 53233-1443

Fax: 414-297-8007