FAST BREAK CLUB MEMBERSHIP FORM Season Ticket Holder Information (please read and check one) I am currently a season ticket holder for the 2017-2018 season of Davidson Men's Basketball. I am NOT currently a season ticket holder. I will contact the Ticket Office at 704-894-2375 to order my seats today. Fast Break Club Membership Levels (check one membership level option) Fast Break Club Individual Membership
$1000.00
Fast Break Club Family Membership
$1500.00
Young Alumni (0-5 years out) Membership Levels Fast Break Club Young Alumni Individual Membership
$500.00
Fast Break Club Young Alumni Family Membership
$750.00
**If you prefer to pay by recurring monthly draft, call the DAF office at 704-894-2396.** All above membership levels are 80% tax deductible. Please contact your tax advisor if you have specific questions. Membership Tax Deductible Information (please read and check one) I understand that my membership in the Fast Break Club includes game day benefits, and my membership is 80% tax deductible. I am unable to take advantage of game day benefits, but would still like to be part of the Fast Break Club. I understand that 100% of my membership fee will be tax deductible. For Family Memberships Only In addition to myself, my Family Membership should include the following member(s) of my family:
Personal Information Name:
Class Yr:
Street: City, State Zip: Phone:
Email:
I was referred by current Fast Break Club Member:
Payment Information I am enclosing a personal check made payable to Davidson Men’s Basketball I am including my credit card information below Name as it appears on credit card: Circle one:
VISA
MC
Discover
Expiration Date:
AMEX
Card Number: CVN Number:
Total Charged to my card: $ Mail your completed form to: Men’s Basketball Office, Box 7158, Davidson, NC 28035-7158