Booster Club One-time Payroll Deduction "*" indicates required fields Name* First Last Address* Street Address City State / Province / Region ZIP / Postal Code Email* Phone*Dog Pack - Individuals MembershipSelect Membership Level Pack of 1 $50 Pack of 2 $100 Family Pack $125 Payment Confirmation*Please check the box below to confirm. Yes, I authorize ASU Mid-South to deduct the cost of my entire booster club membership from the next available paycheck. Select Size for T-shirt #1 Small Medium Large XL XXL XXXL XXXXL Select Size for T-shirt #2 Small Medium Large XL XXL XXXL XXXXL Employee Signature*PhoneThis field is for validation purposes and should be left unchanged.
