Page 5 - Alcorn - Season Tickets, 2019
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mailing and payment info
Name: ______________________________________________________ Address: _____________________________________________________ City: ______________________________ State: ________ Zip:___________ Phone: ______________________________________________________ Email: ______________________________________________________
o Check (Make payable to Alcorn State University) oooo
Credit Card #: ______________________________________________ Exp. Date: ________________________ Security Code: _____________
o I authorize Alcorn State University to charge my card above.
Signature: ___________________________________ Date: _________
GO BRAVES
Detach and mail to:
OFFICE OF ATHLETICS BUSINESS
1000 ASU Drive #509 Lorman, MS 39096
