FestiFall

  Friends of IPTV Donation Form
    Items marked with a are required.

  Contact Information

First and Last Name
Address
City
State
Zip/Postal
Phone Number Type
Email Address (We need your email address to offer you IPTV Passport.)

  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EFT: Please choose which day of the month you would like your gift withdrawn from your account.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.

  How much would you 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

Filter Thank-You Gift list by keyword          
Selected Thank-You Gifts
Thank-You GiftsAmountRemoveViewInfoTrueAmt
      

Recipient Information

Complete this form ONLY if you would like us to send the thank-you gift
to a DIFFERENT address than the donor address.

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone
Comment
Remaining Characters: 120120

Recipient Information

Complete this form ONLY if you would like us to send the thank-you gift
to a DIFFERENT address than the donor address.

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone
Comment
Remaining Characters: 120120

Recipient Information

Complete this form ONLY if you would like us to send the thank-you gift
to a DIFFERENT address than the donor address.

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone
Comment
Remaining Characters: 120120

Recipient Information

Complete this form ONLY if you would like us to send the thank-you gift
to a DIFFERENT address than the donor address.

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone
Comment
Remaining Characters: 120120

Recipient Information

Complete this form ONLY if you would like us to send the thank-you gift
to a DIFFERENT address than the donor address.

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone
Comment
Remaining Characters: 120120

Recipient Information

Complete this form ONLY if you would like us to send the thank-you gift
to a DIFFERENT address than the donor address.

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone
Comment
Remaining Characters: 120120

Recipient Information

Complete this form ONLY if you would like us to send the thank-you gift
to a DIFFERENT address than the donor address.

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone
Comment
Remaining Characters: 120120

Recipient Information

Complete this form ONLY if you would like us to send the thank-you gift
to a DIFFERENT address than the donor address.

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone
Comment
Remaining Characters: 120120

Recipient Information

Complete this form ONLY if you would like us to send the thank-you gift
to a DIFFERENT address than the donor address.

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone
Comment
Remaining Characters: 120120

Recipient Information

Complete this form ONLY if you would like us to send the thank-you gift
to a DIFFERENT address than the donor address.

Recipient First Name(s)
Recipient Last Name
Address Line 1
Address Line 2 (Apt, Floor, Suite, etc.)
City
State
Zip/Postal
Recipient Telephone
Comment
Remaining Characters: 120120

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