Booster Form

Form D

FOR OFFICE USE ONLY DATE: _____________ CHECK # ___________ AMOUNT: _________ INITIALS: ___________

Notre Dame Academy Boosters 2016-2017 (Please print all information.)

Member’s Name___________________________________ (First)

(Last)

Daughter’s Name__________________________________ (First)

Grade in 2016-2017

(Last)

(Circle)

9

10

11

12

Address__________________________________________ __________________________________________ (City)

(State)

(Zip)

Phone Number_________________________________________ EMAIL_____________________________________________

____ Super Booster ($225.00) ____ Eagle Booster - required for participation in two or more sports ($175.00) per student

____ Blue & Gold Booster -

required for participation in one sport per student

($125.00)

 BLUE & GOLD BOOSTER will include two adult tickets to one HOME Notre Dame Basketball, Soccer or Volleyball game.  EAGLE BOOSTER will receive FOUR adult tickets to a HOME Basketball, Soccer or Volleyball game.  SUPER BOOSTER will receive a special Boosters card allowing admission for two adults to all HOME Basketball, Soccer and Volleyball games.

$325.00 maximum per family per school year Please return this form and your check payable to: NOTRE DAME ACADEMY BOOSTERS RETURN PAYMENT WITH FORM DIRECTLY TO THE FINANCE OFFICE

PAYMENT DUE BY FIRST CONTEST OF THE SEASON 2016-2017 Booster Club