30Th Annual Bill Dickey East/West Golf Classicregistration Form

30TH ANNUAL BILL DICKEY EAST/WEST GOLF CLASSICREGISTRATION FORM

Please complete the following information and then e-mail:, fax: 602.258.3412, or mail: 1140 E. Washington St., 103, Phx, AZ85034

Company: / Name: / New attendee / Number of yrs. attended:
Address: / E-Mail:
City: / State: / Zip: / Phone: / Cell:
Club Affiliation: / Handicap:
I do not have an established handicap, my last 5 scores were:
I will compete in the Men’s Division (under 55) / I will compete in the Men’s Senior Division (55-64) my age is:
I will compete in the Super Senior Division (65+) & my age is: / I will compete in the Women’s Division
Major Sponsor $25,000 / Platinum Sponsor $15,000 / Welcome Reception & Pairings Party Sponsor $10,000
Gold Sponsor $10,000 / Entertainment Sponsor $ 5,000 / Awards Ceremony & Dinner Sponsor $10,000
Silver Sponsor $5,000 / Bronze Sponsor $2,500 / Hole Sponsor $1,000
Shirt Size Men: / SM / MED / LG / XL / XXL / Shirt Size Women: / SM / MED / LG / XL / XXL
Form of Payment:
Check (make checks payable to: East/West Golf Classic) / Money Order / Credit Card: Type / Master / Visa / Disc / Amex
Credit Card Number: / Exp. / Total (fees must be included with entry form)
Name as it appears on Card:
Guest Name:

PARTICIPANT 2

Name (Mr./Mrs./Ms.):
Address: / E-Mail:
City: / State: / Zip: / Phone: / Cell:
Club Affiliation: / Handicap:
I do not have an established handicap, my last 5 scores were:
I will compete in the Men’s Division (under 55) / I will compete in the Men’s Senior Division (55-64) & my age is:
I will compete in the Super Senior Division (65+) & my age is: / I will compete in the Women’s Division
Shirt Size Men: / SM / MED / LG / XL / XXL / Shirt Size Women: / SM / MED / LG / XL / XXL
Guest Name:

PARTICIPANT 3

PARTICIPANT 4