Registration
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All fields are Mandatory
I will play in this Charity Golf Outing. ($120)
Name
or
Our foursome will play in this Charity Golf Outing. ($480)
(Please include your golfers names below)
Name
Name
Name
Name
Total number of people attending
or
I am unable to attend the event however, I have enclosed a donation, check payable: Vrishin Chandra Research Foundation
Amount
(US$)
or
I am unable to attend the event
Additional Guests Who Will Attend
(Additional Guests for dinner are $45.00 / Kids under 5 are FREE and 6-12 $10.00/kid)
Name
Kids Name & age
Name
Kids Name & age
Name
Kids Name & age
Name
Kids Name & age
I would like sponsor the Golf Outing (please select below):
Golf Ball Sponsor- $1500.00 (Only 1)
Gold Sponsor - $1000
Silver Sponsor - $750
Bronze Sponsor - $250
Hole Sponsor - $100
Name
Phone
Address
City
State
Select
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Dist of Columbia
Florida
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Louisiana
Maine
Maryland
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South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
E-mail
Confirm E-mail
The following is a summary of funds payable:
No. of Adults
$
No. of Guests
$
No. of Kids
$
Golf Ball Sponsor
$
Gold Sponsor
$
Silver Sponsor
$
Bronze Sponsor
$
Hole Sponsor
$
Total
$
I will mail my check payable to "Vrishin Chandra Research Foundation":
VCRF
5455 Centerbrook Drive
West Bloomfield, MI 48322
Tel: 248.539.8828
or
I will make my donation by PayPal
http://www.suburbancollection.com
http://www.deckancoffee.com
© 2012 Vrishin Chandra Research Foundation. All rights reserved.
