Golf Outing SAVE THE DATE! Register below.. "*" indicates required fields Name First Last CompanyAddress Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail* Golfer Registration Choose Number of Golfers Quantity Price: $175.00 Quantity Player names will be requested at a later date.Government Employee Rate, Choose Number of Golfers Quantity Price: $100.00 Quantity Player names will be requested at a later date. SponsorshipsSponsorships available Tee Sponsor +$100.00 Putting Green +$250.00 Practice Range +$250.00 Refreshment Station +$300.00 Gift Basket Raffle Donation I will donate the following prize(s)I will deliver my raffle prize donation to ESWP before August 8 Southpointe on August 11 Total Method of Payment Credit Card ACH Payment, using bank acct information ESWP Account Raffle Donation Only Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Security Code Cardholder Name Zip Code of Credit Card Billing AddressACH Account Number SelectSavingsChecking Account Type Routing Number Account Holder Name ESWP Acct Number (if known)CaptchaSponsorships Δ