* Please verify your MONTHLY gift amount: $
Please verify your ANNUAL gift amount: $
No Thank You Gift. All supporters receive a MemberCard and will be acknowledged.
Have you donated to WUIS in the past?
WUIS Member ID# (9 numbers on MemberCard)
*
First Name
Last Name
Email
Address
City
State
Zip (only 5 digits needed)
Day Phone (XXX-XXX-XXXX)
Ext
Other Phone
Matching Gift Employer?
Is this a joint gift?
Spouse's/Partner's Title
- Mr. Mrs. Ms.
Spouse's/Partner's First Name
Spouse's/Partner's Last Name
I would like to receive the WUIS My Source e-Newsletter.
I would like to volunteer at WUIS.
Questions, Comments, Concerns: (max 255)
Credit/Debit Card?
Electronic Funds Transfer
University of Illinois Payroll
WUIS Public Radio University of Illinois Springfield One University Plaza, MS WUIS 130 Springfield IL 62703-5407
Phone: (217) 206-9847 Email: wuis@uis.edu