| NAME:________________________________________ |
For All Patrons and Honorary Coaches *Recognition plaque with team picture *Tax deduction |
| ADDRESS: ____________________________________ | |
| ______________________________________________ | |
| ______________________________________________ |
Please Check: New Renewal
| Category: | Amount Remitted: | |
___Student Membership |
$5.00
|
______________
|
___Regular Family Membership |
$35.00
|
______________
|
___Patron * |
$100.00-249.00
|
______________
|
|
$250.00-499.00
|
______________
|
|
$500.00 & Higher
|
______________
|
Number of persons covered by this membership: ______________
Please make checks payable to: Penn
State Wrestling Club, and mail to:
P.O. Box 1103, State College, PA 16804
All contributions above membership fee are tax deductible