MOTHER LODE INVITATIONAL

July 19th, 20th and 21st 2007

ENTRY FORM

 

Property Owner____________________________________   Unit/Lot__________

 

Street Address__________________________________   City__________________

 

State__________   Zip   __________   Phone Number   ____________________

 

Home Club   ______________________   GHIN/NCGA #   ___________________

 

E-Mail Address   _____________________________

 

Golf Glove Size:  Property Owner_________ Guest_________

 

Guest Name____________________________________

 

Street Address__________________________________   City__________________

 

State__________   Zip   __________   Phone Number   ____________________

 

Home Club   ______________________   GHIN/NCGA #   ___________________

 

Tournament Handicap

Low Index 8/1/06 – 7/01/07

 

Deposit $ 100 or Entry Fee Team $480        __________

 

Extra Dinners @ $ 30                                        __________

 

Total Paid (No refunds after 6/15/07)         __________

 

(Balance Due June 1st 2007 if making a deposit to guarantee you’re entry)

 

Make Checks Payable to: Mother Lode Invitational

Send to: P.O. Box 4

Groveland,Ca. 95321

 

Questions Contact:    Tom Bickmore (Co-Chairman) 209-962-5517

tombick@sbcglobal.net

John Baker (Co-Chairman) 209-962-6295

Chris Borrego (PML PGA Pro) 209-962-8620

 

For Committee Use Only:

Date Paid   ________ Balance due June1st 2007   ___________