PANTHER CLUB
PANTHER CLUB MEMBERSHIP Name: _______________________________________________ Maiden Name: ________________________________________ Year of Graduation (if alumnus/a):__________________________ Affiliation with Adelphi: Alumnus
Parent
Staff
Friend
Faculty
EXECUTIVE COMMITTEE PRESIDENT
Home Address: ________________________________________
DENNIS LIND
____________________________________________________
VICE-PRESIDENT
____________________________________________________ Phone: ______________________________________________ Email:________________________________________________ Enclosed is my contribution of $ ___________ for my annual Panther Club membership. (Please make checks payable to Adelphi University) Unrestricted Restricted (indicated team) ___________________________ Please charge my contribution of $ ___________ to my Mastercard/Visa #______________________________________ Exp. date_____________________________________________
SUE TENDY BOARD MEMBERS STEVE CIAVARELLI BILL DABNEY EMILY DORKO LOU FLEGO BARRY GROSS RUSS HUBER RICH ILLSLEY DANNY MCCABE CURTIS MINNIS VERONICA MULLEN DANIELLE PARKS BOB QUINN
Signature_____________________________________________ Date_________________________________________________ Please Return To: The Panther Club c/o Adelphi Athletics Adelphi University One South Ave Garden City, NY 11530
2017-18 MEMBERSHIP BENEFITS