Sponsorship Sign-Up
Company Name :_____________________________________________________
First/Last Name: _________________________________________________ Title:___________________________
City:______________________________________State:____________Zip:__________________________
E-mail:_____________________________________Phone:_______________________________________
Mark X in Selected Desired Sponsorship Below
___Title Sponsorship Level - $50,000
___Beverage Cart Sponsor - $2,500
___Gold Sponsorship Level - $25,000
___Long Drive Sponsor - $1,500
___Silver Sponsorship Level - $10,000
___Hole Sponsor - $350
___Bronze Sponsorship Level - $3,500
Make Checks Payable to:
Pat Dempsey Charities Inc.
OFFICE: 818.300.3615 FAX: 818.951.6884
PayPal Payments:
MAIL: Registration Form & Payment to:
Pat Dempsey Charities Inc.
10651 Johanna Ave.
Sunland, CA. 91040
Method of Payment
Amex Visa MC PayPal Check *
Name on Card
Card #
Exp. Date: Security Code:
___Donate Only – (any $$$ amount)
___Foursome - $2,000
___Single Player - $500
___Dinner Extravaganza - $200
