Eastern Oregon University - Athletics & Recreation - Mountaineer Booster Club


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Mountaineer Booster Club Application

INDIVIDUAL
MEMBERSHIP
2005-2006
PLEDGE FORM

Benefits	Lifetime $10,000	Gold $1,000	Timberline $500	Buckskin $250	Summit $100	Scout $50	Trailblazer $25
Mountaineer Newsletter	X	X	X	X	X	X	X
Halftime Hospitality FB Press Box	X	X
Program Recognition	X	X	X	X	X
EOU Booster Hat	X	X	X	X	X
EOU Booster Polo	X	X	X	X
All-Sports Season Pass	4	2	1
EOU Booster Sweatshirt	2	X
Recognition Plaque	X	X
At the Buckskin level of $250 or above, you will receive 20 game tickets for use at any home games of your choice during the season. It does not include any NAIA playoff games.

Choose Your Level Of Benefits:
Amount of your donation in dollars

Name
Business Name
Address
City
State
Zip/Postal Code
Telephone
E-Mail

EOU Employees Only
If you would like to payroll deduct your donation, then please check the box to the right to receive a payroll deduction form in the mail.

Please indicate the size of sweatshirt needed.
(Buckskin, Timberline and Gold Levels only)

Name as it is to appear in publications:

Billing Address (If different from mailing address)
Name
Address
City
State
Zip/Postal Code

Donation Designation:
If "Other", please indicate your wishes for your donation in the box to the right >>>>

Benefit Declaration

By selecting "YES!" below in the drop down menu, you will receive those benefits as stated in the above table

By clicking the "Donate..." button, you are indicating your intention to make a donation to the Eastern Oregon University Booster Club.
In a few days you will receive your benefits, if eligible, based on the level of you contribution.
A bill will be sent to the above address for the amount indicated.
The Eastern Oregon University athletic department thanks you for your support of Mountaineer intercollegiate athletics!

Eastern Oregon University
One University Boulevard,
La Grande, OR 97850-2899
Phone: 541-962-3672
or call 1-800-452-8639 for Admissions Information

Eastern Oregon University is a member of the
Oregon University System

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