Please Clearly Print Names
Player Name: ____________________________________
In Honor Name(s)		In Memory Name(s)
Total Donation Enclosed                              $
Deadline: This form and Checks in Jan's hands on or before Friday, August 30th
Checks Payable to: CGC 18-Hole Women's Association. Separate Check Please
Mail/Inbox: Mail or leave in the Pro Shop 18-Hole Women's Association mailbox
Mail to:  Jan Baxter, 3 Vicksburg Ave., Harwich, MA 02645