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Golf and Luau Registration Base Access Required Information
Golf & Lunch Industry $60 Resale $60 Lunch Only Industry $15 Resale $15 2018 CAPT Ollie Bates Purina HR ALA Golf Tournament Golf and Luau Registration Name:__________________ # of Guests:____ Address:______________________________ Total Amount Remitted:_______________ Do you have a 4-Some? We’ll need the other 3 names: ________________ Please Remit Payment to: HR ALA c/o Paul Wehner, MDV 1133 Kingwood Ave Norfolk, VA 23502 Base Access Required Information This form must be filled out entirely for each attendee. Please forward form to Mr. Paul Wehner, MDV Name as it appears on License: Driver’s License Number: State Issued: Sponsor: NAS Oceana Golf Course Point of Contact: Randy Clark Ph. #: Event Date: June 14, 2018 100% of Net Proceeds Donated to HR ALA Scholarship and Charity Fund!
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