Direct Support Form
Please print this form & mail to us at: CoolStreams, Inc. ,  Post Office Box 509, Gibsonia, PA 15044

****ALL INFORMATION IS OPTIONAL****
For you convenience, you can type in the info below online before printing it 
(it will not be sent or saved anywhere) Or just print it & fill in on paper.

Name
Street address
City
State/Province   ZIP Code: 
Country
E-mail
Note: We send Membership details by email, so please include a working email address!
To Join using CHECK payment: make payable to "Coolstreams, Inc."  or use below To Join by Credit Card - by MAIL Only!  We do not process online credit card transactions, and this info is NOT sent or saved anywhere on our site.  If you are extra cautious, print this form, then write in your credit card number.
NOTE: This form is for Membership for access to our On-Demand streams only!  If you are also interested in Subscribing for our Continuous MP3 streams at our reduced Membership Subscription rates, please click here for the Membership forms that also include the streams subscription.
  1. Please enter your Membership Contribution Amount:  $  
       OR Select one of these amounts:
        
  2. Select credit card type: 
        
  3. Enter your Credit Card Number: 
        
  4. Expiration Date:     
        
  5. Name exactly as on card:
    Note about DIRECT Credit Card (by mail) transactions: our credit transactions are being provided by another merchant as a service to us, so they will have a different name on your statement.  We will send you that information when you join so that there is no confusion.

1. Which programs do you listen to on CoolStreams? (IMPORTANT! Please check ALL that you listen to.  It will help us provide support to our producers).
NOTE: If you are supporting a specific series under our "Arts Showcase," please type in the name of the group or organization in the comments field below to help support them!
(If you don't remember a series name, clicking the link will open its page in a new window)

Comments?  Please tell us how you found CoolStreams.

Please print form & mail to us at: CoolStreams, Inc. ,  Post Office Box 509, Gibsonia, PA 15044
Please allow us about 10-15 days for a response at this time.  We are working on a better system that will be faster.