WHITTEMORE SCHOOL ALUMNI GOLF TOURNAMENT

PEASE GOLF CLUB

JUNE 10, 2004

REGISTRATION FORM

NAME: ________________________________________________________________

MAIDEN NAME:

NICKNAME FOR NAMETAG: CLASS:

TELEPHONE: EMAIL: ____________________________

ADDRESS:

GUEST NAME(S):                                                       __                                                    

TELEPHONE: EMAIL: ____________________________

ADDRESS(ES):

We will assign you to a foursome.  If you have a foursome, or someone who you’d like to play with, please enter their names below:

Name:                                                            handicap                                                            

Name:                                                            handicap                                                            

Name:                                                            handicap                                                            

Name:                                                            handicap                                                            

REGISTRATION FEE:

TOURNAMENT FEE:            $95 per person                                     = $ __________

PAYMENT METHOD:           _____Check   _____ Visa    ____ Mastercard

(Please make check payable to MBA Alumni Club)

Credit card number _______________________________ Exp. Date (MM/YY)_______

Name as it appears on card ____________________________________

Cardholder signature _________________________________________

If you have special access needs, please check here _____ and you will be contacted to make special arrangements.

Please return your completed registration form w/payment to:

MBA Alumni Club Golf Tournament

Whittemore School, McConnell Hall

15 College Road

Durham, NH 03824

wsbe.alumni@unh.edu