rsm golf scramble registration form 2016_long
TRANSCRIPT
5TH
Annual RSM Golf Scramble
The Hackler Course at Coastal Carolina University
12:30 pm Shotgun Start, Friday, April 15, 2016
All proceeds will go to the RSM Scholarship fund.
Check-in at Hackler Golf Course, 107 Citadel Dr, Conway, SC 29526
Registration Form Player 1
Player 2
Player 3
Player 4
Name _______________________________________________________________________________
Address _____________________________________________________________________________
City ___________________________ State ______________ Zip ______________________________
Telephone _____________________ Email ________________________________________________
Form of Payment: □ Credit Card □ Debit Card □ Cash □ Check □ Pay at the Event
Card Type: □ MasterCard □ VISA □ AMEX
Name on Card: ________________________________________________________________________________
Card Number: _____________________________________ CSC code: __________ Expiration Date: __________
Dustin Thorn, Ph.D. 105 Independence Drive, Williams-Brice Bldg., 151A
Conway, SC 29526 [email protected] (843) 349-2510
* Please make all checks payable to “Coastal Education Foundation”
Entry Fees: Single Team of 4 Total Early Bird (Applies until March 25th) $55 $185 $ ______________
CCU ID# __________ (Discount to all CCU IDs) $60 200 $ ______________
Regular Price $70 $240 $ ______________
Mulligans: $10/each 3 for $20 $ ______________
Donations (If you are unable to participate and still want to make a donation) $ ______________
Total $ ______________
* Included in the entry fee: one round of golf at The Hackler Course, the opportunity to participate in the Silent Auction, games along the way, and complimentary SWAG bag.
All proceeds go towards the RSM Scholarship Fund
Name _______________________________________________________________________________
Address _____________________________________________________________________________
City ___________________________ State ______________ Zip ______________________________
Telephone _____________________ Email ________________________________________________
Name _______________________________________________________________________________
Address _____________________________________________________________________________
City ___________________________ State ______________ Zip ______________________________
Telephone _____________________ Email ________________________________________________
Name _______________________________________________________________________________
Address _____________________________________________________________________________
City ___________________________ State ______________ Zip ______________________________
Telephone _____________________ Email ________________________________________________