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Northwest Missouri State University


Registration for Chip Strong Memorial Golf Tournament

September 6, 2013

Mozingo Lake Golf Course
Tee Time: 1 p.m.

 

Contact Information
Fill these out even if you are not signing up with a team.

First Name:
Last Name:
Address:
City:
State:
Zip Code:
Daytime Phone:
E-mail:

Event Information

Number of Golfers: ($100 per golfer)      Entry fee WAIVED up to 8 playersEntry fee WAIVED up to 4 players
List the members of your group: If you do not have a group of four, we will put you in a group.
Team 1:
Team 2:
Sponsorships: Classic ($2000 - includes entry fee for 2 teams)
Double Eagle ($1000 - includes entry fee for 1 team)
Eagle ($500)
Birdie ($150)
Golf Cart ($50)
No Sponsorship ($0)
Name on Sponsorship:
I would like to donate: $
Additional Notes:
(include teammate names
if paying separately)

Total: $

Cardholder Information

Cardholder information is same as contact information above?
Yes    No
First Name:
Last Name:
Address:
City:
State:
Zip Code:
Phone:
E-mail: