Golf Entry Form

Attention All Golfers

The Fall 2011 IRS Golf League Tournament is being sponsored by:

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

WHEN:	Monday – October 10th (Columbus Day) – 1:30pm Shotgun Start
WHERE:	Riverside Golf Course – 3000 Riverside Parkway – Grand Prairie
COST:	LibertyOne members - $45, non-members - $55
Format:	Ellis Campbell Jr Trophy Flight – Stroke play, low gross All golfers – 2 person (cart partner) best ball, handicapped
PRIZES:	Ellis Campbell Jr Trophy, Best Ball, Door Prizes!!

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

PLAYER 1 INFORMATION
First Name:
Last Name:
Phone Number:
Email Address:
IRS Golf League Player?	Yes No
Ellis Campbell Jr Flight?	Yes No (For IRA Golf League Players)
Avg Score - 18 Holes:
Debit My LibertyOne Account Number:	Yes No ( For The Entry Fee)
Account Number:

PLAYER 2 INFORMATION
First Name:
Last Name:
IRS Golf League Player?	Yes No
Ellis Campbell Jr Flight?	Yes No (For IRA Golf League Players)
Avg Score - 18 Holes:
Debit My LibertyOne Account Number:	Yes No ( For The Entry Fee)
Account Number:

Contact Kim Purintun at 469-212-0242 or kpurintun@libertyonecu.com with questions.
Checks payable to: LibertyOne Credit Union, 2221 E Lamar Blvd STE 110, Arlington, TX 76006