Please mark the number and type of passes you want to purchase on this form.  Check should be made to E.C. Glass Athletic Department. 

Your Name:________________________________________________

Mailing Address:____________________________________________

_________________________________________________________

_____Student Pass - $25 - admits E.C. Glass student to ALL regular season home    
                                                   athletic contests.

_____Football Season Pass - $20 - admits one to all FIVE regular season home games
               Heritage; Culpepper; Albemarle; George Washington; Patrick Henry

_____Hilltopper Pass - $55 - admits one to ALL regular season home athletic contests.
                                             (adult version of Student Pass)

_____Senior Citizen Pass - $25 - admits one (60 & over) to ALL regular season home                                                                  athletic contests. (same benefits as Hilltopper Pass)

Mail this form and check to:

E.C. Glass High School
Athletic Department
2111 Memorial Avenue
Lynchburg, VA  24501