GNP/ICP Scholarship Golf Classic
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GNP/ICP Scholarship Golf Classic
Registration Info
Contact Name
Company
Address
City
State
ZipCode
Bus.Phone
Fax
E-mail Address
Please reserve my space as a:
Gold Sponsor ($5,000.00)
Silver Sponsor ($2,500.00)
Individual Sponsor ($750.00)
Longest Drives Sponsor ($1,500.00)
Closest To The Pin Sponsor ($1,500.00)
Tee sign Sponsor ($1,500.00)
Please accept my donation $
I would like the following ad space:
No ad space required
Full Page ad ($1,000.00)
Half Page ad ($500.00)
Qtr. Page ad ($250.00)
Name only ad ($50.00)
My Check For:
$
is enclosed.
(Please make check payable to GNP/ICP Scholarship Fund)
Please charge
$
to my:
Visa
Master Card (MC)
Discover
Credit Card Number
Expiration Date
CVV2
01
02
03
04
05
06
07
08
09
10
11
12
/
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
Mail or fax this entry form to:
David Breslow
GNP/ICP Scholarship Golf Classic
5016 La Canada Blvd.
La Canada, CA 91011
Fax 818-864-6171
All Contributions are tax deductible within legal limits of the law. Tax ID #95-4867562
Name
Enter billing address
GNP/ICP Scholarship Golf Classic
Golfer Information
Golfer #1
Full Name
Nick Name
Company
Address
City
State
ZipCode
Bus.phone
E-mail address
Index/Handicap
Shirt
select
Small
Medium
Large
X large
XX large
Will you attend
dinner?
VIP Reception?
Golfer #2
Full Name
Nick Name
Company
Address
City
State
ZipCode
Bus.phone
E-mail address
Index/Handicap
Shirt
select
Small
Medium
Large
X large
XX large
Will you attend
dinner?
VIP Reception?
Golfer #3
Full Name
Nick Name
Company
Address
City
State
ZipCode
Bus.phone
E-mail address
Index/Handicap
Shirt
select
Small
Medium
Large
X large
XX large
Will you attend
dinner?
VIP Reception?
Golfer #4
Full Name
Nick Name
Company
Address
City
State
ZipCode
Bus.phone
E-mail address
Index/Handicap
Shirt
select
Small
Medium
Large
X large
XX large
Will you attend
dinner?
VIP Reception?
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