Page 5 - Alcorn - Season Tickets, 2020
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mailing and payment info
Name: _________________________________________________________ Address: _______________________________________________________ City: ______________________________ State:_______ Zip: ___________ Phone: ________________________________________________________ Email: _________________________________________________________
❏ Check (Make payable to Alcorn State University) ❏❏❏❏
Credit Card #: ____________________________________________________ Exp. Date:_______________________________________ Security Code: ____
❏ 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
