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Midlands Golf Benefit 2010 Registration
Name*
Company (if applicable)
Address*
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State*
Zip*
Home phone*
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Email*
FCA HDCP Index*
Others in foursome
Name player 2*
Address player 2*
City player 2*
State player 2*
Zip player 2*
FCA HDCP Index player 2*

Name player 3*
Address player 3*
City player 3*
State player 3*
Zip player 3*
FCA HDCP Index player 3*

Name player 4*
Address player 4*
City player 4*
State player 4*
Zip player 4*
FCA HDCP Index player 4*
Please check all that apply:

Title Sponsor - $10,000

Corporate Sponsor - $5,000

Tournament Sponsor - $2,500

Team Sponsor - $1,250

Sign Sponsor - $150
If sponsoring signs, how many?

Please include team mulligans (2 per golfer)

Mulligan per player - $25.00 each

Team Mulligan - $100.00 per team

Mail checks to:

Midlands FCA Office
100 Executive Center Drive
Suite A-4
Columbia, SC 29210

For more information phone: (803) 798-1142
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