|
|
|
Main Contact Name_____________________________________
|
|
|
|
|
|
|
|
Address_______________________________________________
|
|
|
|
|
|
|
|
City, State, Zip________________________________________
|
|
|
|
|
|
|
|
Phone________________________________________________
|
|
|
|
|
|
|
|
Email ________________________________________________
|
|
|
|
|
|
|
|
Package (circle one)
|
|
1. Single Golf and Dinner $100
|
|
2. Team of 4 Golf, Dinner and hole sponsorship $450
|
|
3. Hole Sponsorship only $100
|
|
4. Dinner Only (PRE-REGISTRATION REQUIRED) $ 20
(Please list names of those attending Dinner Only)
____________________________________________
____________________________________________
Total : $_______
|
|
Checks payable to: Dan Dowson Benefit
Return completed form and payment to:
Dan Dowson Golf Benefit
|
|
2506 W. 10th Avenue
|
|
Indianola, IA 50125
|
|
Registration Deadline: June 1, 2010
Please list players names & ALL email addresses below:
(limited to ages 18 & older)
________________________________________ Email: _________________
________________________________________ Email: _________________
________________________________________ Email: _________________
________________________________________ Email: _________________
A limited number of Dobbers Up Special Edition caps are available by PRE-ORDER ONLY.
Please see "Order Form" for additional information. You may send registration
and order forms together.
|
|
|