TIN: 68-0226944

Name:________________________________
Company:_____________________________
Address:______________________________
City:_________________   Zip:____________
Phone:_____________
Desired Sponsorship
___Presenting    ___Shirt     ___ Greens    ___ Eagle   ___ Super Tee   ___ Tee   
___ Business Card    ___Individual   ___ Foursome
--> Sponsorship Amount_______
Please make checks payable to Agape Villages, Inc.

Please charge my: ___VISA   ___MC  ___DISCOVER  ___AmEx
Card Number_________________________
Exp. Date:___________ Amount:__________
Signature:_____________________________

Golfer 1_________________Phone:___________
Address:________________________________ shirt size_____

Golfer 2________________________Phone: _____________
Address:________________________________ shirt size_____

Golfer 3_________________________Phone_____________
Address:________________________________ shirt size_____

Golfer 4_________________________Phone:____________
Address:________________________________ shirt size_____