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Requested Registration for Monthly Meetings

»Request registration online using this form then contacting the person below in reference to payment;

»or register by printing this form, then completing and mailing it with payment to:

Tracy Fleming
PMA California District
7025 Firestone Blvd.
Buena Park, CA 90621
Phone: 714-735-5105
Fax: 714-670-3311
tfleming@amada.com

Please fill out this form for each person wishing to attend.

Requested Registration for the 15th Annual Golf Outing

Choose Your Registration:
Company Information:
*Company
*Company Membership Status	Member Nonmember
*Company Address
Company Address
*Company City
*Company State/Province
*Company ZIP/Postal Code
*Company Country
*Company Phone
Company Fax
*E-mail
Donations
Sponsorships
Yes, our company would like to sponsor the golf outing at the following level:
Par 3, Hole-in-One Sponsor $250 Beverage/Snack Sponsor $200 Hot Dog Lunch Sponsor $250 Tee Sponsor w/Signage $150

Primary Golfer Information:
*Prefix	Mr. Mrs. Ms.
*First Name
*Middle Initial
*Last Name
*Phone
*E-mail
*Purchase On Course Game Pkg - $40 Yes No
Second Golfer Information:
Prefix	Mr. Mrs. Ms.
First Name
Last Name
Phone
E-mail
*Purchase On Course Game Pkg - $40 Yes No
Third Golfer Information:
Prefix	Mr. Mrs. Ms.
First Name
Last Name
Phone
E-mail
*Purchase On Course Game Pkg - $40 Yes No
Fourth Golfer Information:
Prefix	Mr. Mrs. Ms.
First Name
Last Name
Phone
E-mail
*Purchase On Course Game Pkg - $40 Yes No
(A copy of this request for registration will be sent to the provided e-mail address. If you do not receive it within 24 hours, please contact Tracy.)

Special Arrangements/Requirements