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REGISTRATION This form must be accompanied by your payment. We must receive your registration by June 1, 2007 ~ Sponsorship Level ~ ____ Gold Sponsor $5000 ____ Silver Sponsor $2500 ____ Bronze Sponsor $1200 ____ Tee Sponsor $100
~ Program Book Ad Space ~ ____ Full Page $150 ____ Half Page $100 ____ Quarter Page $75 ____ Business Card $50 ____ Name Listing $25
~ Tournament Participants ~ ____ Players $175 ____ Foursome $700 ____ Dinner Guest $50
Contact Person ____________________________________________________ Business Name ____________________________________________________ Address __________________________________________________________ _______________________________________ Phone __________________________________ TOTAL ENCLOSED $_____________ Form of Payment □ CHECK payable to Alzheimer’s Association, RI Chapter VISA # ___________________________________________________ MasterCard # ______________________________________________ Expiration Date ____________________________________________ Signature _______________________________ Please list names of players in your foursome: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Please send completed form and payment to: Alzheimer’s Association, Rhode Island Chapter Attn: Bella Garcia 245 Waterman Street, Suite 306, Providence, RI 02906 |
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