ATHLETIC MEMBERSHIP APPLICATION
2007 - 2008
Parent(s) Name(s) ___________________________________________________
Student(s) Name(s)___________________________________________________
Sport(s)____________________________________________________________
Address____________________________________________________________
Phone No.
_________________________________________________________
City
_______________________________State _________Zip______________
Ø Please fill in dollar amount
($_________________) of the selected level and circle appropriate level below:
(Note - minimum amount for required
"Pay-to-Play" fee is $225.00)
GOLD
BLUE
BULLDOG
FAN
Ø Certificate for
your special gift and/or car decals will be mailed to you upon receipt of
payment
Ø Please make your
check payable to St. Ursula Academy and mail to the following address:
If you have any questions,
please feel free to call Coleen G. Vogelgesang,
Assistant to the Athletic Director, at 513/961-3410, extension 119.