ECCPA GOLF OUTING
1360 Clifton Ave #327
Clifton, NJ 07012
Phone: 973-726-6213 Fax: 973-726-6217

NAME __________________________________________________

STREET_________________________________________________

CITY___________________________________________________

STATE____ ZIP__________ PHONE__________________________

Enclosed is $_____________ to register_________golfers


HERE IS MY FOURSOME:
________________________________________________________

________________________________________________________

________________________________________________________

________________________________________________________


___ Please place me in a foursome. My handicap is ______


___ I would like to sponsor a tee/green. I have enclosed a 
check for $150.00 Please identify sponsor as follows:
________________________________________________________


___ I would like to register ___________________________
for the dinner buffet only, at $100 each.  I have enclosed
a check for $_____________