28th Annual R. Brinkley Invitational Reservation Form

For additional information please call
Rosanne C. Slattery, Development Director
T: (516) 747-2606  ext 18  or Email: rcslattery@licadd.org

To secure reservations please print this form and mail to:

LICADD 
207 Hillside Avenue,
Williston  Park, NY 11596

OR Fax to: (516) 747-0714

The Creek and Piping Rock's popularity requires payment for reservations. 
Payment must be received by September 2, 2008 to confirm reservation. 
Two caddies and one cart will be provided for each foursome. 

All contributions are tax deductible as provided by law.

I (we) will be pleased to attend the 28th R. Brinkley Smithers Golf Invitational benefiting LICADD 
on Monday, September 22, 2008 at the The Creek Club & Piping Rock, Locust Valley.

Please reserve the following:

___       Platinum Sponsor at $25,000

___       Gold Sponsor at $10,000

___       Silver  Sponsorship at $6,000

___       Bronze Sponsorship at $3,000

___       Foursome at $2,200  

___       Individual Player  at $600

   ___       Dinner Reception at $150

 

Fields will be extremely limited for speed play. Please indicate your course preference. 

_____The Creek             ______Piping Rock             ______No preference

We will do our best to honor all request; however, course preference cannot be guaranteed.
To ensure proper placement, please submit payment with reservation.

We would like to support the 2006 Golf Invitational with an underwriting opportunity:  

___       Dinner Sponsor                $10,000                    ___ Hole  Sponsor                     $1,500
                                                                                      (includes complimentary Pin Flag)

___       Golf Cart Sponsor            $5,000                      ___ Beverage Cart Sponsor   $1,500
                                                                                            (Creek only)

___       Brunch Sponsor               $3,500                      ___ Photography Sponsor      $1,000

___       Driving Range Sponsor    $3,000                      ___  Print Sponsor                  $500       

___       Putting Green Sponsor    $2,500                       ___ Pin Flag(s)                       $200

___       Awards Sponsor              $2,000                       ___ Tee Sign(s)                      $150

                                                                                     ___ Raffle Ticket(s)                $100

                                                                                     ___ 6 Raffle Tickets               $500

 

I/ we are unable to attend but wish to contribute $____________.

Golf Participants:

To ensure proper placement please list names of foursome and handicap:

_____________________________________
Name                                                 Handicap

_____________________________________
Name                                                 Handicap

_____________________________________
Name                                                 Handicap

_____________________________________
Name                                                 Handicap

 

We request that if possible, payments be made by check, which is not subject to additional credit card fees. 
Please check with your company's matching grant plan, as many will match employee's contributions.

Enclosed is my check made payable to LICADD for $__________.

 

Visa              MasterCard              Amex      Total $__________.

Account Number _____________________  Expiration Date ____________

Signature ____________________________________  Date ____________

Please PRINT name EXACTLY as it should appear in all printed materials

Name ____________________________________________________ ____

Title ________________________ Company ________________________

Address ______________________________________________________

City ________________________ State _______ Zip ____________

Phone _______________________ Fax ______________________

E-mail ________________________________________________

 

All proceeds will benefit The Long Island Council on Alcoholism and Drug Dependence, Inc.
a 501(c)3 organization. Contributions are tax deductible as allowed by law.
For additional information contact Rosanne C. Slattery at 516 747-2606 x18 or Kari E. Storaekre at x15.