Pledge Form KXCI Pledge Form Membership TypeNew MemberRenewing or Returning MemberAdditional Gift (on existing membership)Gift MembershipSustaining MembershipYesOne-Time GiftSustaining Pledge LevelsSustaining pledge gifts are charged monthly and provide security and sustainability for KXCI. If you would prefer making a ONE TIME gift, choose the "One-Time Gift" option under Sustaining Membership above. Pledges of $10/month or above qualify for giftsSustaining Pledge Levels$10/month$20/month$50/month$100/monthOtherPledge Amount (per month) Yearly TotalOne-Time Pledge LevelsPledges of $100 or more qualify for gifts. One-Time Pledge Levels$50$75$150$500 Challenger Gift$1000 Challenger GiftOtherOther Amount TotalGiftsDonations over $100 are eligible to receive KXCI thank-you gifts. For each $100 you contribute, we'll send you a token (included with your thank-you letter from KXCI) that can be redeemed at KXCI's Armory Park office for T-shirts, water bottles, CDs and more. For $100 you'll receive one gift, $200 gets you two gifts, etc. If you'd like to have an even bigger impact, you can also decline to receive thank-you gifts. That way, the full amount of your donation will go towards supporting the great music and community you enjoy on KXCI. Thinking about a larger gift of $500 or more? Consider letting KXCI use your donation as Challenge Gift to spur additional giving. For more info about making a Challenge Gift, contact Cathy or Amanda at (520) 623-1000 or email email@example.com or firstname.lastname@example.org. GiftsNo gift, I want the entire amount to support KXCIYour InformationEnter your contact information below. If this is a gift membership use the Comments box below to enter the recipient's name and mailing address. KXCI member contact information is never sold or exchanged for any reason.Name* First Last Email* PhoneAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20182019202020212022202320242025202620272028202920302031203220332034203520362037 Expiration Date Security Code Cardholder Name Favorite Showsi.e. Your Morning Brew, Blues Review, Electric Feel, etc.Additional Comments or Questions? Tell us anything you think that we should know!For example: updates to address, phone, or credit info. If this is a gift membership, be sure to tell us the gift recipient's name, address, phone number, and email address so that we can get their membership set up! Employer NameMany people can increase the impact of their gifts through employer matching programs. Please let us know who you work for (if applicable). At this time, Apple, IBM, UnitedHealth, Texas Instruments, and Intuit all match their employees' gifts- and other employers may do so as well. Check with your company's HR dept. for more information, as eligibility can vary.