Registration: 11:00 – 12:00 ~ Lunch: 12:00 – 1:15 ~ Shotgun Start: 1:30 

                                                                          Cocktails and Dinner: 6:30

                                      $170 per golfer (all inclusive) ~ $70 Dinner Guest Only

                          NAME: __________________________________________________________________

                          ADDRESS: _______________________________________________________________

                          PHONE: __________________      E-MAIL ____________________________________

                                                      PLEASE LIST ALL PLAYERS IN YOUR FOURSOME:

                                  1) _______________________________________________

                                  2) _______________________________________________   

                                  3) _______________________________________________

                                  4) _______________________________________________

                     Please make checks payable to the Perry Como Lodge #2846 and mail with this form to:

                                                             Rick Annichiarico, Golf Chairman (724-3697)

                                                              159 Old Willets Path, Smithtown, NY 11787

                                                          SPONSORSHIPS

                 Tee Sponsor ($100) ____     Lunch Sponsor ($500) ____

               Cart Sponsor ($300) ____   Dinner Sponsor ($1000) ____