KLVX Application

Becoming a member of your local Public Broadcasting Station, KLVX-Channel 10, makes you eligible for membership in Silver State Schools Credit Union.

Please complete and submit the simple application below to join KLVX-Channel 10.

Individual donations from viewers like you represent the single largest source of support for KLVX. With quality programs like Masterpiece Theatre, Frontline and Antiques Roadshow, KLVX invites you to be more inspired and show your support by making a pledge. TV wouldn't be the same without KLVX. KLVX wouldn't be the same without you. Thank you!

Member Benefits
One year of KLVX Antenna Magazine Membership eligibility to Silver State Schools Credit Union Click here to complete the SSSCU membership application A Thank You Gift (based upon the amount of your gift)

Contribution
Type
Dollar Amount
Other Amount	$

Personal Information
Title:
Name
Address

City
State
Zip
Phone Number	-
Email Address

Billing Information

Deduct funds from my SSSCU Account*
*By checking this box, you certify that the personal information provided is correct and true and you authorize Silver State Schools Credit Union (SSSCU) to deduct the amount indicated above (dollar amount) from the designated member account number and account type (checking, savings, etc.).

Account Number
Social Security Number
Share

OR
Charge my credit card**
**By checking this box, you certify that the personal and account information provided is correct and true and that you authorize KLVX Channel 10 to deduct the amount indicated above (dollar amount) from the credit card indicated.

Card Type
Name on Card
Card Number
V-Code	(3 digit number on the right side in the signature area on the back of the card.)
Expiration Date

Billing Address (Same as Personal Information)
Address

City
State
Zip Code

Comments
Any special requests or comments?

Your submission of this application constitutes acceptance of the terms and conditions for membership with KLVX Channel 10. It does not constitute membership with Silver State Schools Credit Union.

If you are not yet a member of Silver State Schools Credit Union, you may complete and submit the online membership application. You should indicate that you are a member of KLVX as your eligibility requirement for SSSCU membership.

Please click the submit button to send your pledge to KLVX.