Yes! I want to HELP!  Sign me up for the SCRAMBLE 4 H.E.L.P. 

Please complete and submit the form

Last Name           Middle Name            

First Name    

Address         State

City                  Zip   Contact Person

List players and/or Tee/Green sign information below.

Name of Golfer (s) Playing                                                                                                               USGA Handicap

(Entry fees are tax-deductible as allowed by law)

Corporate Sponsorship fee for $525.00: Includes Tee/Green sign and four players.

Tee/Green Sign Sponsorship only for $150.00

Individual Player Entry for $100.00 ($400/foursome)

*11:00 a.m. Registration begins   * Noon Putting Contest   *1 p.m. Shotgun Start

All sponsorships include greens fee, electric carts, lunch, refreshments (on course), and prizes.  Dinner will begin as players complete course.

* Please include $15.00 for each non-golfing guest who will be attending the dinner.

* Because this is a fundraising event, no refunds or rain date will be provided.

   Thank you for your time and support of LD students at MU. You play a vital role in the   

   success of the students. You do make a big difference!  See you on October 2nd and THANKS!

Please check which method you prefer:

My Check  will be mailed immediately.

Please mail to:

Diana Porter, Treasurer

Scramble 4 H.E.L.P.

Myers Hall

520 18th Street

Huntington, WV 25703

Tel: 304-696-5220 or 6311

Fax: 304-696-3231

I will give the Business Manager my credit card number by calling (304)696-5220.

My credit card is Visa Master Card  Expiration Date : Month Year

 The name that appears on the credit card is

Sorry, I cannot attend, but I would like to sponsor a student

to play!

I would like to make a donation to the H.E.L.P. Scholarship Fund.