(PRINT THIS FORM, OR DOWNLOAD THE FORM BELOW, AND MAIL)
DOUBLE T ASSOCIATION
PO Box 6785
Lubbock, TX 79493-6785
e-mail: dta@ttu.edu
Name:
Address:
City, State, Zip:
Phone: (home) ________________________ (work) ____________________________
E-mail:
Name
As you want on the certificate. You may include
a nickname.
Sport Coach’s Name
Year AD’s Name
Sport
Year
Sport
Year
Payment $250 (cash) ____ (check) ____
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Make the check to Double T Association