Registration Form
ACA/NE Golf Tournament | September 6, 2019 | Red Tail Golf Course | Devens, MA
(Credit Card Required)
Sponsor Packages | Please Check
Titanium Package - $3,360
Gold Package - $1,650
Hole in One Contest - $900
Beverage Cart - $880
Awards Dinner - $750
Golf Carts # 1 - $875
Golf Carts # 2 - $875
Breakfast - $600
Chipping Contest - $550
Boxed Lunch - $500
Longest Drive - $330
Closest to the Pin - $330
Hole Sponsor - $275
Straightest Drive - $330
Raffle Donations
Please purchase a raffle prize for my company:
Amount:
$100
$200
$300
$400
$500
We will donate the following raffle items:
Name # 1
Email # 1
Company
Check One
Golf Only - $190
Awards Lunch Only - $55
Volunteer
Shirt Size
Small
Medium
Large
XL
XXL
Name # 2
Email # 2
Company
Check One.2
Golf Only - $190
Awards Lunch Only - $55
Volunteer
Shirt Size
Small
Medium
Large
XL
XXL
Name # 3
Email # 3
Company
Check One.3
Golf Only - $190
Awards Lunch Only - $55
Volunteer
Shirt Size
Small
Medium
Large
XL
XXL
Name # 4
Email # 4
Company
Check One.4
Golf Only - $190
Awards Lunch Only - $55
Volunteer
Shirt Size
Small
Medium
Large
XL
XXL
Total Fees
Payment
*
Master Card
VISA
American Express
Account Number
*
Expiration Month
*
- -
01
02
03
04
05
06
07
08
09
10
11
12
Expiration Year
*
- - - -
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
Security Code
*
First Name
*
Last Name
*
Cardholders's Email
*
Company
Phone
*
Street
*
City
*
State
*
- -
AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
*
