$4,000 GOLD SPONSORSHIP LEVEL

MY INFORMATION
First Name:
Last Name:
Email Address:
Company:
Title:
Address:
City:
State:
Zip:
Business Phone:
Attend Dinner:
Number of years supporting the Shopko Foundation
Golf Classic, including current year:

SHOPKO PARTNER
Your Shopko Business Partner:

CONFIRMATION AND BILLING PREFERENCE
Yes, we will participate in the Shopko Foundation Golf Classic at the GOLD ($4,000) level:
(Please - no changes once your payment method is submitted.)
Billing Preference:

GOLFER 1

First Name:
Last Name:
Email Address:
Company:
Title:
Address:
City:
State:
Zip:
Business Phone:
Golfer's Gender:
Reserve Rental Clubs:
* Note: Limited number of clubs available. $25 rental fee will be applied.
Shirt Size: