In order to submit your donation, please print this page or choose File>Edit Page
and then fill out the form .  Then fax to us at 835-2847 or email the completed File>Edit Page document to kchu@alaska.net. We will then send you a completed membership form to your address.
Thank you in advance for your support and generous gift!  As a loyal listener of KCHU, you will be helping to maintain and enhance the unique brand of quality programming you and all our listeners expect. 

Our new premiums are here!

Mt. Drum tees in Texas Orange, Chestnut, and Maroon,

Mini AM/FM radio's

Sign up to be a member of KCHU KXKM KXGA Terminal Radio Inc.

 

Date_____________________

Name_________________________

Address_______________________

_____________________________________________

_____________________________________________

Phone #__________________

 

Email Address________________________

Contribution Amount_____________

Credit Card # or Check #______________________________

Expiration date:___________

Student/Senior    $25        Magnet
Individual            $35        Coffee Mug or mini am/fm radio
Family                 $50         Tee Shirt specify size and color

Supporting          $75         Nalgene Water bottle or Tote bag

Patron                 $100       Your Choice of 2

Sustaining           $250       Your Choice of 3

Special                $500 or more  Exclusive membership 

Please circle your choice of gift or gifts.  For the Tee Shirts please specify size and color:  Small, Med., XLg, Texas Orange, Chestnut or Maroon

Favorite Programs & Listener Comments:

 

Will your employer match your contribution?

 

May we use your name on the air to say Thank You?