Gail Riecken–District 77
Indiana House of Representatives
and
Scott Pelath-Ind. House Minority Leader
July 19th Golf Scramble
Eagle Valley Golf Course – Friday, July 19, 2013
10350 Petersburg Road Evansville, IN 47725 – (812) 867-7888
Registration & Lunch: 10:30 – 11:45 a.m. CST Evansville Time
Shotgun Start: 12:00 Noon CST –
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REGISTRATION FORM
_____, Yes, we would like to be $4,000 DOUBLE DOUBLE EAGLE Sponsor and provide a check of $2,000 to both Gail Riecken and Scott Pelath. Includes a foursome of golf, lunch, dinner and a DOUBLE DOUBLE Sign displayed prominently at the clubhouse. Enclosed is our Double Double Eagle Contribution check of $2,000. Even if you cannot play golf, please consider an Eagle Sponsorship!
_____, Yes, we would like to be a $2,000 Eagle Sponsor. Includes a foursome of golf, dinner and Eagle Tournament Sponsor Sign prominently displayed. The $2,000 check can be made payable to Gail Riecken or Scott Pelath or $1,000 to each of the candidates.
_____, Yes, we would like to be a $1,000 Birdie Sponsor which entitles you to a foursome of golf, dinner and a Tournament Sponsor sign displayed on a Sponsor Tee Box. The $1,000 check can be made payable to Gail Riecken or Scott Pelath or $500 check to each of the candidates.
_____, Yes, we would like to be a $500 Sponsor which entitles you to a foursome of golf, dinner and a Sponsor sign displayed on a Sponsor Tee Box. The $500 check can be made payable to Gail Riecken or Scott Pelath or $250 to each of the candidates.
_____, We would like to have a foursome to play golf at a cost of $300 per foursome. The $300 check can be made payable to Gail Riecken or Scott Pelath or $150 to each of the candidates.
_____, I would like to play golf as an individual at a cost of $75 per person. The $75 check can be made payable to Gail Riecken or Scott Pelath.
HOLE SPONSORS FOR NON GOLFERS
_____, We would like to be a $100 Hole Sponsor and have our sign displayed on a prominent hole. Enclosed is $100 that can be made payable to either Gail Riecken or Scott Pelath. Take two hole sponsorships, one for Gail Riecken and one for Scott Pelath.
SIGN TO READ:______________________________________________________________
July 19th Golf Scramble
Eagle Valley Golf Course – Friday, July 19, 2013
10350 Petersburg Road Evansville, IN 47725 – (812) 867-7888
CONTACT NAME: _____________________________ ADDRESS: ____________________
CITY: ____________________________________ ZIP: _______ PHONE: (____) __________
ORGANIZATION:______________________________________________________________
Total Amount Enclosed: $___________ Email Address: ________________________________
List Names of Golfers – Use TBA for names to be announced. Please confirm early as the field may fill up quickly.
1.___________________________________ 2. _____________________________________
3.____________________________________ 4. _____________________________________
Checks are payable to:
Gail Riecken for State Representative District 77
5935 Knight Drive, Evansville, IN 47715
Scott Pelath for State Representative District 9
1824 Manhattan Street, Michigan City, IN. 46360-4452
MAIL REGISTRATION TO:
Golf Outing/USW 104
P.O. Box 247, Newburgh, IN 47629
QUESTIONS?
Call Golf Chairman, Charlie Wyatt@ 812-455-9108 or email Charlie at charlie104pac@aol.com
