|
|
|
| Name |
|
| Mailing address |
|
| City |
|
| State |
|
| Zip code |
|
| Phone |
|
| E-mail Address |
|
| Amount of
contribution: $ |
|
|
| "Quick Gift" (One-time
gift or payment) |
|
| or Monthly on the |
3rd 18th
of each month |
| Designate
my payment |
General Donation
Golf Shoot-Out $100 Player Fee
Other
Sponsorship
This is my pledge for the Golf
Shoot-Out. I
sponsored:
|
| Card Name |
|
| Expiration Date |
|
| Card Number (no spaces) |
|
