M@Neese Athletics - sidearm.sites.s3.amazonaws.com

M@Neese Athletics Ticket Office Box 92735 – Lake Charles, LA 70609 Tel: (337) 562-4MSU Fax: (337) 475-5220

  Name  of  Group:  _____________________________   Group  Contact:  ______________________________     Phone:  ________________________       Email:  ____________________________  

 

     

     

     

     

Please  mail  tickets  to:  _______________________________            _______________________________            _______________________________  

 

Date*  

Opponent  

Saturday,  September  12,  2015   Saturday,  September  26,  2015   Saturday,  October  10,  2015   Saturday,  October  24,  2015   Saturday,  November  7,  2015     *All  kickoffs  at  6:00pm  

Incarnate  Word   Mississippi  College   Southeastern  Louisiana   Northwestern  State   Sam  Houston  State  

Total  Adult:    Total  Sr.  Citizen:   Total  Youth:   Total  Child:    

_______  x   $16  =   _______  x   $12  =   _______  x   $8  =   _______  x   $4  =   Grand  Total:  

$______________   $______________   $______________   $______________   $______________  

Adult  (18+)   Sr.  Citizen  (65+)   Youth  (13-­‐17)   Child  (4-­‐12)   $16     $12     $8     $4                        

                   

 

                   

                   

Payment  Information:  

Cash     Check     Credit  Card  (Visa,  MasterCard,  Discover)     CC  Number:  _____________________________________  Exp:  ______________   Name  on  Card:  ______________________________________________________   Signature:  ___________________________________________________________