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Men’s Varsity O Alumni Association 2015 Membership Dues
Varsity O Annual Dues ........................................$50.00
Emeritus Dues ....................................................$25.00
(Must be 70 years of age or older as of 1-1-2015)
Lifetime Membership ................................... $1,000.00
Additional Scholarship Contribution $
Total Enclosed $
As a condition of membership in this organization, I certify
and agree to the following:
I have received the Ohio State Department of Athletics educational
pamphlet titled “Your Guide to Ohio State Athletics (Buckeye
Insider).” I have read it and I understand it.
I have not knowingly engaged in any violations of NCAA, Big
Ten, or University rules and policies applicable to Ohio State’s
intercollegiate athletics program, and I am currently not aware of
any such undisclosed violations.
I will abide by all NCAA, Big Ten, and University rules and policies
applicable to Ohio State’s intercollegiate athletics program that are
set forth in the educational pamphlet referenced above, and will
report to the Director of Athletics or his/her designee, and to the
Associate Athletic Director for Compliance, any violations of those
rules and policies of which I become aware.
I understand that if I engage in conduct that, in Ohio State’s
reasonable judgment, is a violation of NCAA, Big Ten, or University
rules and policies applicable to Ohio State’s intercollegiate athletics
program, both this organization and e Ohio State University have
the right to withhold any benets or privileges relating to Ohio
State’s intercollegiate athletics program to which I may otherwise be
entitled (ex. athletic tickets).
All membership payments must be made with either a personal check or
credit card (on-line only). Cash payments for membership dues will no
longer be accepted. Additionally, the name on checks and credit cards
used for renewal payments must match the name on the membership
account. Exceptions to this “matching name” payment policy will be
granted provided the member has a direct familial relationship with
the payment source. Direct familial relationship is dened as: mother,
father, sister, brother, daughter, son, wife or husband.
Men’s Varsity O Alumni Association Membership Application
Print or Type All Information
Name
Address
City, State, Zip
Phone
Preferred E-mail
Sport(s) Year(s)
Birthday
This is updated contact information
I do not want to be included in the member directory
Payor relationship to member:
self mother father sister brother
daughter son wife husband
Please make checks payable to: Varsity O
Application, payment and compliance form must be received by January 31, 2015 to receive your football ticket application.
I am a New Member
I am a Renewing Member
I am a Lifetime Member
Full Name of Member (Print or Type) Varsity O Membership Number
Signature of Member Date
Member Certication of Compliance
THIS FORM MUST BE SIGNED AND RETURNED WITH YOUR DUES BY THE ESTABLISHED
DEADLINE IN ORDER FOR YOUR MEMBERSHIP TO BE PROCESSED.
Men’s Varsity O Alumni Association
The Ohio State University • Department of Athletics • Fawcett Center 8th Floor
2400 Olentangy River Rd. • Columbus, Ohio 43210 • Phone 614.688.3707 • Fax 614.247.7014
For additional information on NCAA, Big Ten, and University
rules and policies, please visit OhioStateBuckeyes.com or call the
Compliance Oce at 614.292.2681.
DO NOT CUT
Your membership number
is located on the mailing
label of this newsletter. It’s
also your online password.
Contributions or gifts to e Ohio State University Men’s Varsity O
Alumni Association are NOT tax deductible as charitable contributions.