Golfer Registration   Print this and mail to the address at bottom or bring to the main office for the Department of Biological Sciences.

Golfer's Name:

Address:

City:


State: Zip:

Phone:


If registering as a foursome, please list your playing partners:
Player 2's Name:

Player 2's Telephone (optional):


Player 3's Name:

Player 3's Telephone (optional):


Player 4's Name:

Player 4's Telephone (optional):


Amount enclosed:
($28 per person is tax-deductible)

Please make checks payable to Wright State University & mail to:
Golf Scramble c/o Eileen Porter,
Biological Sciences WSU
Dayton OH 45435-0001
No Refunds After September 21, 2007