Fundraiser for the Marble Church Arts Centre Sponsored by the
Tweed & Area Arts Council
“4 Person Scramble” Sunday June 10 , 2012, Poplars Golf Club, Tweed. Shotgun Start at 11 a.m.
$95 per player. ($85 for Poplars members)
PRE-Registration recommended. Limited to 144 Spaces. Register today!
We would like to encourage you to enter a mixed team this year.
All profits benefit the Marble Church Arts Centre. Please make cheques payable to:
Tweed & Area Arts Council. Fill out the form and mail to:
Jack Vance Golf Classic c/o Don Herbertson, 92 Stoco Road, R.R.#4 Tweed, Ontario, K0K 3J0.
A charitable tax donation receipt will be issued to each participant.
Name: _____________________________________________________________________________________
Address: ___________________________________________________________________________________
City: ____________________________________ Province: _________ Postal Code: _______________
Phone #: ________________________ e-mail: __________________________________________________
PAYMENT ENCLOSED # of people ________ X $95 ($85) = __________________
I would like to make a donation of $ _________ to the Tweed & Area Arts Council
I would like to attend the dinner & reception ONLY (cost $25) ____ X $25 = ______
I would like _____ additional tickets for the dinner & reception $25 = __________
I would like a tax receipt in my name: _______________________________________
We need a tax receipt for each player (Name & Address required below)
Please arrange a foursome for me
I prefer to play with:
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