26th Annual Golf Outing September 30th, 2021

Personal Information

Name *

First

Last

Daytime Phone *

Email *

Email

Confirm Email

Billing Address *

Address Line 1

City

State

Zip Code

Outing Information

Number Attending Golf Outing, Reception & Dinner

$300.00 Per Person (If you have more than one foursome. Please register each foursome separately.)

List Other Golfers in Group:

Golfer 1 (Full Name) *

Golfer 1 (Email)

Golfer 2 (Full Name) *

Golfer 2 (Email)

Golfer 3 (Full Name) *

Golfer 3 (Email)

Golfer 4 (Full Name) *

Golfer 4 (Email)

Number Attending Cocktail Hour Only

$50.00 Per Person

PLATINUM EVENT SPONSOR:

Yes $5,000

Includes two paid foursomes, plaque awarded to sponsor & sign on display at sign-in

GOLD LUNCHEON SPONSOR:

Yes $2500

Includes paid foursome, plaque awarded to sponsor & sign on display at lunch

SILVER DRIVING RANGE SPONSOR:

Yes $1000.00

Includes paid twosome, plaque awarded to sponsor & sign on display at range:

COMPANY, INDIVIDUAL OR FAMILY TEE SPONSOR

Yes $200.00

Sign on display at Tee

Sponsorship to Read *

Unfortunately, I cannot attend but please accept my contribution of:

Additional Contribution

Grand Total

$ 0.00

Select Payment Option *

Paypal (Credit Card)
Pay By Check

Please make check payable to “The Jack DeVito Foundation” and mail with this form to:

The Jack DeVito Foundation334 Underhill Ave., Suite 4D

Yorktown Hgts., NY 10598

If you have any questions, please contact us at 914.273.3626 or email [email protected]

The Jack DeVito Foundation is a not-for-profit (501-C3) corporation

Thank you for supporting the youth in our communities

***Additional opportunities to contribute through raffles, contests & auctions - (FYI Minimum tips for caddies $20/person) ***