FallWinter201Pledge FormRadio at Wesleyan UniversityComplete and return this form along with your check money order or credit card information to WESU RADIO 45 Broad Street 2nd Floor Middletown CT ID: 873778
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1 Fall / Winter 201 Pledge F orm To m
Fall / Winter 201 Pledge F orm To make a tax deductible donation to WESU Radio at Wesleyan University : Complete and return this form along with your check, money order, or credit card information to: WESU RADIO - 45 Broad Street 2nd Floor Middletown, CT 06457 You can also make a secure echeck, debit, or credit card donation online at www.WESUFM.org Please enter your gift amount here I have enclosed my payment by the followingmethod [ ] Check or Money Order (payable to WESU) [ ] Credit card (please provide info below) First and Last Name : Mailing address Phone : CC type: Exp. Date: CC #: Email address: 3 digit security code on back of card: If this donation is in support of a specific program ming , please tell us the name of the program and or DJ here: Choose your li mited edition WESU thank you gift (s)view the items online atwww.wesufm.org/pledge Q ty P ledge amount Premium Description Please indicate size (s) Do not send a thank you gift. I want my entire donation to support WESU! $35 Short Tee Shirt – Y our choice of shirt color [ ] navy blue or [ ] white [ ] SM [] M [] LG [] XL [] XXL $4 5 Long Sleeve - ( green and white ink on black shirt ) [ ] SM [] M [] LG [] XL [] XXL $50 Tote bag – White ink on black bag $65 Baseball cap - White embroidered on navy b lue [ adjustable one size fits all ] $75 Zippered Hoody sweatshirt - White ink on black ] SM [] M [] LG [] XL [] XXL $10 ** Please consider including an extra $ 10 to help cover our ever increasing shipping and handling costs If you would like a thank you gift mentioned by one of our DJs that isn ’t listed on this form, please describe it (and the show where you heard about it) here: We can also accommodate larger than XXL in most items. Please note custom order here & include an additional $10 $35 Short Sleeve Poker hand on whiteor navy Blue shirt selectone above) $45 Long Sleeve Green and white ink black shirt one sided $50 Tote/Record bag Whiteink on blackcotton canvas $65 Baseball cap White embroidery on navy cap $75 Zippered Hoody Sweatshirt White ink on black Graphic printed over left breast