Friends of Iowa PBS Donation Form

  Contact Information

First and Last Name
Address
City
State
Zip/Postal
Phone Number Type
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EFT: Please choose which day of the month you would like your gift withdrawn from your account.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 4th or the 18th of the month.
By checking this box, I am authorizing Friends of Iowa PBS to charge my bank account or credit card account monthly until I notify Friends of Iowa PBS 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 Iowa PBS Passport and can choose to receive the Friends MemberCard.

  Thank-You Gift

Filter Thank-You Gift list by keyword          
Selected Thank-You Gifts
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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 Iowa PBS MemberCard!  Please choose one:


Weekly Program Highlights

British Community e-Newsletter

  Iowa PBS 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
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
The Iowa PBS Kids Club is complimentary for those who pledge $120 or more.
You can enroll up to four kids age 10 or younger.
 
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