I wish to participate as follows:

____ Event Sponsor @ $5000                               ____ Fireman’s Friend @ $500

____ Gold Sponsor @ $1500 (2 foursomes, hang sign)

____ Silver Sponsor @ $1250 (1 foursome, hang sign)

____ Corporate Foursome @ $600 (no sign)

____ Premium Tee Sponsor @ $200        ____ Foursome @ $300 / per foursome

____ Standard Tee Sponsor @ $100        ____ Individual Golfer @ $75

Reservations call

Mark at 724-678-5267 or John at 724-377-1156 or

   Nicholas at 724-322-1265

Make checks payable to : East Bethlehem Twp. VFC

All entry fees  & all golfers’ names are to be paid and submitted by Aug. 1, 2010.

Event sponsorship as well as gold & silver sponsors need to be turned in by

June 30, 2010.

Mail to : EBVFC “Strive to Survive” PO Box 445 Fredericktown, PA 15333.

            TEAM # 1 (Gold & Silver)                                        TEAM # 2 (Gold)

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     Any problems with copying this form should call one of the above phone #.