Conejo Free Clinic Fall Classic Golf Tournament
Please
print and FAX or mail your completed entry form
to the address at the bottom of this page.
Entry Fees and Sponsorship: (select the package(s) of your choice)
 |
Foursome Package - $800 | |
__________ Guest Dinner(s) @ $30 each | |
|
Individual Package - $400 |
|
Contact me about donating an auction item. |
|
|
Individual Player - $200 | |
Tee or Green Sponsor - $250 ($200 with any package) Name on sign:________________________________ |
|
| Total enclosed:______________ | ||||
| Names of players: | |||||||||
|
|||||||||
| Your
Name: ______________________________________________________________________
________________________________________________________________________________ |
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| Phone #:_________________________________________________________________________ | |||||||||
| E-mail address:___________________________________________________________________ | |||||||||
Mastercard or Visa # ____________________________________ |
Expiration:_______________ | ||||||||
| Name on Card:____________________________________________________________________ | |||||||||
| Signature:________________________________________________________________________ | |||||||||
| - OR - | |||||||||
| Make checks payable to: Conejo Free Clinic - GOLF | |||||||||
Please FAX or mail your completed form to:
Conejo Free
Clinic
80 East Hillcrest Drive, #102
Thousand Oaks, Ca. 91360
Phone: (805) 379-1918
FAX: (805) 497-4099
Tax ID: 95-3177953