Athletic Hall of Fame Dues Form

| ______________ | Enclosed please find my tax deductible voluntary |
| dues payment of $50 |
Monies raised will be allocated to the following:
|
Inductee Blazers
|
Banquet Expenses
|
|
Inductee Photographs
|
Operating Costs
|
| ______________ | Enclosed please find my additional contribution to |
| the Hall of Fame Scholarship Fund in the amount | |
| of $______________. | |
| Scholarship fund money makes it possible to award | |
| scholarships to needy student-athletes attending | |
| Boston University. |
Please make checks payable to: Boston University Hall of Fame
Mail to: Boston University Hall of Fame c/o Boston University Department of Athletics
285 Babcock Street, Boston, MA 02215
Name:________________________________