University of Maryland Athletics

General Admission Seats: _______   at $8.00 = $ ________

($10 on game day, if available)



                                 Handling Fee $ 3.00



                             Total Amount Due $ ________





Name: ________________________________________________________

 



ADDRESS: _____________________________________________________





City: ________________________  State: _____  ZIP: ___________





Daytime Telephone: (    ) ___________________________







Make check payable to: Towson State University



Or charge my:





Visa _____  MasterCard _____





Credit Card Number: ________________________________





Expiration Date: _________







Signature: ____________________________________________________









Please return this form and payment to:

Towson State University

Athletic Ticket Office

University Union Building

Towson MD 21204