I Love IPTV

Yes, I want to make my gift an ongoing monthly Sustaining Membership!

  Contact Information

First and Last Name
Address
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State
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Email Address

  Payment Type



EFT: Please choose which day of the month you would like your gift withdrawn from your account. You may choose either the 8th or the 21st of the month.

Signature: By typing my name in this box, I am authorizing Friends of Iowa Public Television to charge my bank account or credit card account monthly until I notify Friends of IPTV or my bank that I wish to end this agreement.

    Please select your MONTHLY contribution amount.   Items marked with a are required.









        Monthly amount I would like to give:
    • Gifts of $35 or more will receive Advance, our monthly program guide.
    • Gifts of $60 or more will also receive IPTV Passport and can choose to receive the Friends of IPTV MemberCard.

  Thank-You Gift

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Recipient Information

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone

Recipient Information

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone

Recipient Information

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone

Recipient Information

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone

Recipient Information

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone

Recipient Information

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone

Recipient Information

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone

Recipient Information

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone

Recipient Information

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone

Recipient Information

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone

  Other benefits you may choose.

Friends of IPTV MemberCard Please choose one:


Weekly Program Highlights

British Community e-Newsletter

  IPTV Kids Club

Kid First and Last Name
Kid Birthdate
Drop Down Calendar
Address Line 1
Address Line 2
City
State
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Kid First and Last Name
Kid Birthdate
Drop Down Calendar
Address Line 1
Address Line 2
City
State
Zip/Postal
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