response card

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Player or Dinner Guest Information Player or Dinner Guest Information Name 1 __________________________________________ Name 11 ____________________________________________ _________________________________________ Name Address __________________________________________ Address __________________________________________ ____________________________________________ City,Phone St., Zip _____________________________________ City, St., Zip _____________________________________ E-mail ___________________________________________ Name 2 __________________________________________ Name _________________________________________ Name 22 ____________________________________________ Address __________________________________________ Phone ____________________________________________ Address __________________________________________ City, St., Zip _____________________________________ City, St., Zip _____________________________________ E-mail ___________________________________________

Name 3 __________________________________________ Name Name 3___________________________________________ 3 __________________________________________ Address __________________________________________ Phone ____________________________________________ Address __________________________________________ City, St., Zip _____________________________________ E-mail ___________________________________________ City, St., Zip _____________________________________ Name 4 __________________________________________ Name _________________________________________ Name 44 ____________________________________________ Address __________________________________________ Phone ____________________________________________ Address __________________________________________ City,E-mail St., St., Zip _____________________________________ ___________________________________________ City, Zip _____________________________________ If you have anyany questions please call If you have questions, have any questions please call Kelly Peters the Development Office atat 516-609-2000 x313 Kelly Peters at or email [email protected] 516-609-2000 x214 or e-mail [email protected] 516-609-2000 x214 or e-mail [email protected]

School for Language and Communication Development and ABLE Community Services

17th Annual

Golf Outing Monday, August 8, 2016 The Creek

Locust Valley, NY Steak & Lobster Feast on the Beach

Golf Packages Individual Golfer ____ Foursome

Please Fill Out All Information

____

___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

$600

Name: ___________________________________________

$2,300

Company: ________________________________________

Sponsorships & Dinner

Address: _________________________________________

Event Sponsor $15,000 Dinner Sponsor $10,000 Shotgun Sponsor $7,500 Brunch Sponsor $5,000 Cocktail Reception Sponsor $3,500 Table Sponsor $2,500 Halfway House Sponsor $1,800 Entertainment Sponsor $1,000 Refreshment Sponsor $800 Flag Sponsor $400 Tee Sponsor $350 Golf Cart Sponsor $250 Raffle Basket Sponsor $100

City, St., Zip:_____________________________________

___ Steak and Lobster Feast $225 ____ I cannot attend but would like to make a donation of $__________

Phone: ___________________________________________ E-mail:___________________________________________

Amount to charge: ■ Visa

■ MasterCard Master Card

$__________ ■ Amex

■ Discover

Credit Card #:____________________________________ Exp. Date: ________________ Security Code: _______

Signature ___________________________________ Enclosed is a check for: (Please make payable to SLCD)

$__________

Please mail to SLCD Development Office 100 Glen Cove Avenue, Glen Cove, NY 11542