Name __________________ Phone: __________________

Individual/Team Options:

___ Entering to play $100

___ Entering a team to play $400

___ Making a cash donation

$ ______

$ ______

$ ______

Sub Total $ ______

Registration/Donation FormI wish to contribute to this charity event by:

Name/Company ____________________________________________

Address ____________________________________________

Name/Company ____________________________________________

Address ____________________________________________

Name/Company ____________________________________________

Address ____________________________________________

Name/Company ____________________________________________

Address ____________________________________________

Corporate Options:

___ Entering a team to play and an exclusive hole sign $625

___ Donating goodie bag items (Minimum of 100 items needed)

___ Exclusive hole sign $300

___ Inclusive hole sign at the putting green $100

___ Scoreboard sign (8 ½ x 11) $50

___ Door prize/raffle item over $100 (Scoreboard sign included)

$ ______

$ ______

$ ______

$ ______

$ ______

Total Contribution

(Note: this is tax deductible a receipt will be provided upon request) $ ______

Payment method: Check * Visa * Master Card * Discover (Make checks payable to PPF Inc.)

Email forms to: dhesse@acdi.com or bheinrich@acdi.com

or Send via mail to: 7435 New Technology Way, Ste A, Frederick, MD 21703 Attn: Charity Golf