Become a Sustaining Member

Please complete the following form. Fields marked * are required.

Personal Details

*First Name

*Last Name

*Street 1

Street 2

*City

*State

*Zip Code

*Daytime phone

*Email

May we contact you via email?

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What is your favorite program?

May we thank you on air?

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Electronic Funds Transfer

Bank Routing Number

Bank Account Number

Savings Account?

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Electronic signature

To confirm you have read our EFT Policy and agree to ongoing bank debits, please sign above in the format of /First Last/

Credit Card Information

Credit Card Number

Expiration Date

Format MM/YY

Let us know what WTCI means to you

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