Make a money order or check payable to: NEDGA and mail to: Dayleena Doan
540 E. Lincoln Avenue
Myerstown, PA
17067-2215
Deadline: August 7, 2011
After August 7, 2011 - Golf Package @ $220.00
Money Order or Certified Check is required
Your Name:
______________________________________________________________
Address:
_________________________________________________________________
City:
_____________________________
State:
_________
Zip Code:
______________
Email:
___________________________________________________________________
Golfer's entry fee: ($200.00 or
$220.00 if after 08/07/2011
) . . .
$_________________
Guest Banquet: No. of Guest: ____ x $20.00 . . . . . . . . . . . . . . . . +
$_________________
_________________
_________________
Total Amount enclosed: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$_________________
Name(s) of Guest for Banquet: _______________________________________________
_________________________________________________________________________
Circle one:
GHIN
or
Avg. Score
___________