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I authorize WVIA to deduct my Sustaining donation from the bank account or credit card submitted on this form. The first deduction will occur on or shortly after today's date and continues monthly until I notify WVIA that I wish to change or end this agreement. WVIA can be reached by phone at (570) 602-1110 (M-F, 9-5).

Northeastern Pennsylvania Educational Television Association (WVIA/WVIA Public Media) is a registered charitable organization in Pennsylvania, New York and New Jersey.

The official registration and financial information of Northeastern Pennsylvania Educational Television Association may be obtained from the Pennsylvania Department of State by calling toll free, within Pennsylvania, 1-800-732-0999. Registration does not imply endorsement. Northeastern Pennsylvania Educational Television Association does business as WVIA and WVIA Public Media.

A copy of the last annual report filed by Northeastern Pennsylvania Educational Television Association may be obtained by either writing 100 WVIA Way, Pittston, PA 18640 or from the Office of the Attorney General, Department of Law, Charities Bureau, 120 Broadway, New York, NY 10271.

INFORMATION FILED WITH THE ATTORNEY GENERAL CONCERNING THIS CHARITABLE SOLICITATION AND THE PERCENTAGE OF CONTRIBUTIONS RECEIVED BY THE CHARITY DURING THE LAST REPORTING PERIOD THAT WERE DEDICATED TO THE CHARITABLE PURPOSE MAY BE OBTAINED FROM THE ATTORNEY GENERAL OF THE STATE OF NEW JERSEY BY CALLING 973-504-6215 AND IS AVAILABLE ON THE INTERNET AT http://www.state.nj.us/lps/ca/charfrm.htm. REGISTRATION WITH THE ATTORNEY GENERAL DOES NOT IMPLY ENDORSEMENT.