Lake Superior State University
Lake Superior State University
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Laker Club Membership Form

You can also download and mail in our printable form

* Required Fields

Your Information
* Name
Class Year
Spouse Name
Spouse Class Year
* Address
* City
* State/Prov
* Zip/Postal Code
  Check this box if you live in Chippewa County
Home Phone
Cell Phone
* Email
Matching Gift? Double your Impact!
* Choose Your Membership Level
Laker Gold ($1,200 or more)
  Season Hockey Tickets   ( One Ticket   Two Tickets)
  GLIAC Sports Pass
  Parking Pass
Laker Blue ($1000-$1,199)
  Season Hockey Tickets    ( One Ticket   Two Tickets)
  GLIAC Sports Pass
  Parking Pass
Coaches ($500-$999)
  Parking Pass
Varsity ($100-$499)
I do not wish to receive benefits. (Use my full gift amount to benefit LSSU student atheletes.)
* Designate Your Membership Gift
Direct my gift at the above Membership Level to the following areas of support:
   Laker Club Fund:  $  (supporting athletic scholarships)
Men's Sports: Women's Sports:
     $ Basketball      $ Basketball
     $ Tennis      $ Tennis
     $ Golf      $ Golf
     $ Cross Country      $ Cross Country
     $ Track and Field         $ Track and Field
     $ Hockey      $ Volleyball
  Gift Total $
Don't forget to order your Laker Club jacket(s)!
Select quantity for each size.

Nylon Jacket - $50 each

Fleece Jacket - $50 each
(if applicable)

Laker Club Jacket
You may also place your order at the LSSU Barnes & Noble Bookstore (sample sizes are available to try-on in store).

Total Amount Due (including jackets, if selected) $


Donations will be recognized in compliance with the LSSU Foundation Current Benefits Table. All benefits that exceed the IRS regulation level will be deducted at Published Fair Market Value. LSSU Foundation's Gift Acceptance Policy applies to all gifts. All gifts are compliant with all NCAA and Conference regulations. (April 2004)


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