On-Line Registration Form

 Date

 

 Name

 

 Organization

 

 Address

 
 

 Home Phone    

 Work Phone      

 Fax                    

 Email                 

  I am purchasing a single player slot.

  I am purchasing a twosome. My players will be as follows:

 Player 1              

 Player 2              

                            

                            

  I am unable to participate. Please accept my contribution
       of $ in lieu of participation.

 I will pay with PayPal Check via mail.

 I understand that my registration will not be processed untiil payment is  received.

PLEASE NOTE: Langston Junior Boys & Girls Golf Club has been determined by the IRS to be a not-for-profit 501(c)(3) organization (1996). For individuals, $50.00 of each player fee is tax deductible. For businesses, other tax deductibility rules may apply. Please consult your tax advisor for information on the tax deductibility of your sponsorship.