YOUR MEMBERSHIP INFORMATION Name ________________________________________________________________________________________ Street address _________________________________________________________________________________ City________________________________________ State_________________ ZIP _________________________ Email _________________________________________________________________________________________ Primary phone _________________________________________________________________________________ Shirt size (if applicable to giving level) _____________________________________________________________ ¨ I am a former Vanderbilt Football player. Graduation year_________________________ Degree or major______________________________________ Jersey number__________________________ Position _____________________________________________ Honors earned ______________________________________________________________________________ NCC Gridiron Club giving levels (please select one) ¨ Anchor $10,000 ¨ Star V $5,000 ¨ Dore $2,500 ¨ Captain $1,000 ¨ Gold $500 ¨ Black $150 ¨ Other $ ________________ Your donation information ¨ Check (Make payable to Vanderbilt and designate “NCC Gridiron Club” in the memo line.) ¨ Credit Card ¨ American Express ¨ Discover ¨ MasterCard ¨ Visa Cardholder’s name _____________________________________________________________________________ Card number _________________________________________________ Expiration Date __________________ Payment options ¨ One-time charge ($_____________) ¨ Monthly payments ($_____________ for _____________ months) Signature _____________________________________________________________________________________ You may also make your NCC Gridiron Club gift online at vu.edu/gridiron. ¨ I wish to decline all tangible benefits associated with this gift. (Unless benefits are declined, contributions to the NCC Gridiron Club cannot be paid through donor advised funds, foundations or IRA distributions, as they do not allow individuals to receive goods and services in exchange for their contributions.) Mail to: Vanderbilt University Gift Processing, PMB 407727, 2301 Vanderbilt Place, Nashville, TN 37240-7727 Have NCC Gridiron Club questions? Call (615) 322-4114 or email [email protected]. JOIN THE NCC GRIDIRON CLUB TODAY! 2014–15 MEMBERSHIP The NCC Gridiron Club is a restricted fund benefiting Vanderbilt Football. The membership year runs July 1, 2014, through June 30, 2015. NCC Gridiron Club members are also National Commodore Club members and receive priority credit; however, an additional gift to the NCC unrestricted annual fund is necessary for priority seating and parking. Thank you for your gift to Vanderbilt Football. Every gift in every amount makes a lasting impact. *T15CA9999999999*