Membership Renewal Application

Renovacion de Membresia

Note: All fields of the form are required.

Friday, May 9th, 2008

Your Name: Your ADDRESS: Numero de Telefono / Phone Number Su E-mail / Your e-mail: SU Mensage / Your Message:

AMOUNT

CHECK

CASH

FECHA/DATE
PROGRAMA

Por Ser Parte de "La Nuestra" Gracias.
Tipo De Membrecia / Type of Membership
Business / Commercial $150		Non-Profit / No Lucritiva $75
Family / Familiar $50		Single / Individual $20

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La fundacion de difusiones bilingues le agradece su promesa de apoyo. Favor de enviar su contribucion tan pronto le sea posible. Recuerde que su contribucion es decucible de impuestos anuales.

Regrese esta copia con su donacion.

The Bilingual Broadcasting Foundation, Inc., thanks you for your pledge. Please remit as soon as possible. Your contribution is completely tax deductible.

Print out a copy of this to send along with your donation.

FOR YOUR RECORDS
KBBF FEDERAL TAX ID# 23-7134263

PO Box 7189 | Santa Rosa, CA 95407
707.545.8833 | Fax: 707.545.6244