Full Name:                

                         E-mail Address:   

                         Company Name:   

                         Street Address or P.O. Box:         

                         City, State, & Zip:  

                         Phone (Cell):         (Work):

Please reserve (number: )) Grand Slam Tickets for our Team at $ 20 per ticket.
*Grand Slam Tickets include 2 Mulligans, Longest Drive & Closest to Hole entry*

$ Total (Golf Entry)

I would like to purchase        holes at $100 each  ◊ Total Hole Purchase: $       


I cannot attend, but here is my donation to the Calcasieu Women's Shelter (check enclosed).

Donation: $       

All payments must be submitted no later than April 25, 2008. You have the option to pay online on the next page once the form is submitted, or you can mail your check to the address below.

Mail check to:
Calcasieu Women's Shelter, P O Box 276, Lake Charles, LA 70602

phone (337) 436-4552 ◊ fax (337) 436-8327 ◊ email cws@cwshelter.org