LOYOLA CREASE CLUB MEMBERSHIP FORM Contact Information NAME: _____________________________________________________________ ADDRESS: __________________________________________________________ City, State, ZIP: ______________________________________________________ PHONE: ______________________ EMAIL: ______________________________ I would like to join The Loyola Crease Club at the: _______ All-American Level - $750 – Participation at the $750 All-American Level includes a $500 tax-deductible charitable gift; the remainder is payment for the specific benefits listed. _______ Tournament MVP Level - $500 - Participation at the $500 Tournament MVP Level includes a $350 tax-deductible charitable gift; the remainder is payment for the specific benefits listed. _______ All-Conference Level - $250 - Participation at the $250 All-Conference Level includes a $175 tax-deductible charitable gift; the remainder is payment for the specific benefits listed. _______ Starting Lineup Level - $100 – Participation at the $100 Starting Lineup Level includes a $75 tax-deductible charitable gift; the remainder is payment for the specific benefits listed. Credit Card Information Credit Card (Visa, MC, AMEX, Discover) exp date Please charge my credit card for the amount indicated in the member level chosen above.
Signature Date Please return this completed form by mail or fax to 410-617-5133. Checks are payable to Loyola College – Women’s Lacrosse - 4501 North Charles Street – Baltimore, MD 21210 For any additional information please contact Chris McFarlane at 410-617-5409. | 
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