Title Sponsor - DOC

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					                                     Become a Partner in the Fight Against Hunger…
                                        Register for the 6th Annual Golf Tournament
                                                            June 1st, 2009
                                                Springfield Golf & Country Club


                                              Golfer Registration Form
Sponsor or Team Name (feel free to be creative!)        _____________________________________________


 Golfer Information


 Name               ____________________________                     Name                _________________________________

 Address ____________________________                     Address _________________________________

 Address ____________________________                     Address _________________________________

 Telephone          ____________________________                     Telephone           _________________________________

 E-Mail             ____________________________                     E-Mail              _________________________________




 Name               ____________________________                     Name                _________________________________

  Address ____________________________                    Address _________________________________
                Registration Information                                             Fee Worksheet
  Address ____________________________
 Payment:                                                 Address _________________________________

 Telephone          ____________________________                     Telephone           _________________________________
 Checks should be made payable to Food for Others.
                                                                      Foursome of Golfers          $600 x ____ = _______
 To pay by credit card, please fill in information below.
  E-Mail             ____________________________                    E-Mail         _________________________________

                                                                       Individual Golfers               $150 x ____ = _______
 Visa        ____   MasterCard       ____


 Number      ____________________________ Exp _______
                                                                       Grand Total                                        $ ________

 Card holder name ________________________________


 Signature _______________________________________
                                         2938 Prosperity Avenue Fairfax Virginia 22031 * 703-207-9173

 Register:
2938 Prosperity Avenue Fairfax Virginia 22031 * 703-207-9173

				
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posted:9/17/2012
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