Registration Form This form is to be printed out and mailed or faxed. (See bottom of form.) Yes, I want to help shoot for a cure for Pulmonary Hypertension! Tournament City & State:_________________________

Name:	______________________________
Company Name:	______________________________
Address:	______________________________
City, State, Zip:	______________________________
Phone:	______________________________
Email Address:	______________________________

Please reserve _____ golfers.

Names	Phone	Handicap
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

Would You Like To Sponosor Any Of The Following?
Platinum Title Sponsor	Gold Sponsor
Silver Sponsor	Hole-In-One Sponsor
Shirt Sponsor - Logo on right sleeve	Shirt Sponsor - Logo on left sleeve
Hole Sponsor	Tee Gift/Tee Bag Sponsor

I wish to donate an Auction/Raffle item:	______________________________
I wish to make a cash donation or pledge of:	______________________________

Please print out this form, fill-in and mail to (enclose check and make out to Pulmonary Hypertension Association, a non profit 501(c)(3) foundation): The Pulmonary Hypertension Assocation c/o (See Web Site For Desired PHA Tournament Director Address and Fax)