2018 Football Season Tickets BGSU Faculty and Staff Payroll Deduction Form Please complete this form and return the signed copy to the BGSU Ticket Office in the Stroh Center, or mail to BGSU Ticket Office, 1535 East Wooster Street, Bowling Green, OH 43403. ACCOUNT #:
BGSU ID #:
LAST NAME:
FIRST NAME:
HOME ADDRESS:
CITY:
STATE:
ZIP:
BGSU EMAIL:
CAMPUS PHONE:
EMPLOYMENT STATUS:
□ FACULTY □ ADMINISTRATIVE □ CLASSIFIED
BGSU Athletics is offering current BGSU Faculty/Staff ONE free General Admission season ticket. You may upgrade your ONE free GA ticket to Chairback and pay only $35 on that one seat. You may also upgrade your ONE free GA ticket to a Bench and pay only $25 on that one seat. ^As a benefit of being a Falcon Club member individuals will receive one free parking pass for the 2018 Football Season. If you are not a Falcon Club member and would like to purchase a parking pass, please fill out the column in the table and add it to your total.
SPLIT PAYMENTS INTO:
□ 4 PAYMENTS □ 6 PAYMENTS □ 8 PAYMENTS
Seating Category General Admission (1 Free) GA Additional Falcon Four Pack GA (Min. 4 Tickets) Falcon Four Pack East Bench (Min. 4 Tickets) Bench Upgrade Bench Additional Chairback Upgrade Chairback Additional Premium Bench* Premium Bench Additional* Premium Chairback* Premium Chairback Additional* Season Parking Pass^
Season Quantity TOTAL Price Free $66 $45 $50 $25 $70 $35 $80 $25 $70 $35 $80 $50 Processing Fee $10.00
Total *Requires an additional per-seat donation to the Falcon Club
Funds will be withdrawn from your paycheck beginning in the month of August 2018. If you have any questions, please call the ticket office at 419-372-0000 or email
[email protected] Authorization Agreement I authorize BGSU to deduct from my earnings the total cost of my purchase of 2018 BGSU football season tickets in the amount described under “Total” above. If my employment with BGSU should terminate for any reason before the said amount has been paid in full, I hereby authorize BGSU to deduct the full amount then-remaining due and owing on my purchase from my final BGSU paycheck.
By signing this form, I certify that I have read, fully understand and authorize the above payroll deduction. SIGNATURE:
DATE:
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