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:

Candy Villarreal
PMA Northwest Ohio District
P.O. Box 642
Sylvania, OH 43560
Phone: 419-450-1480
Fax: 845-698-9289
nwohiopma@yahoo.com

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

Cancellations made after October 5th cannot be refunded, substitutions are welcome.

Requested Registration for the Annual Golf Outing

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
(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 Heather.)

Donations & Sponsorships
If you would like to sponsor a golf hole, please select the number of holes below: ($100 per hole)


Registration Fees:
Please select if you would like to registaer as individual golfers or as a foursome:


Golfer Information:
Golfer #1
Name
Phone
Event
Golfer #2
Name
Phone
Event
Golfer #3
Name
Phone
Event
Golfer #4
Name
Phone
Event

Special Arrangements/Requirements