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Join us!

13th Annual Insurance & Risk Management Octoberfest Golf Scramble

Friday, Sept. 24, 2010

Country Club of Terre Haute

www.indstate.edu/insurance/golf

Register via this form, call the Golf Hotline at (812) 237-8876 or email irmgolf@indstate.edu

Prefix:

Dr.
Mr.
Mrs.
Miss

First Name:

Maiden Name (if applicable):

Last Name:

Company Name (if applicable):

Work Title:

Company Address:

Company City:

Company State:

Company Zip Code:

Company Phone Number:

Company E-mail:

Would you or your company consider a sponsorship? (see sponsorship opportunities information at www.indstate.edu/business/insurance/docs/2010Sponsorship_opps.pdf)

Yes
No

Please select your payment option:

I am sending a check payable to Indiana State University (memo Insurance & Risk Management Program)
Please invoice us, send to the attention of:

Name of golfers in foursome (and shirt sizes if Platinum Sponsor):

Golfer 1
Golfer 2
Golfer 3
Golfer 4

Name of golfers in second foursome (if applicable):

Golfer 1
Golfer 2
Golfer 3
Golfer 4

If you selected a sponsorship option above that includes a hole sponsorship, please type below the copy you want to appear on your company's sign or send your company's high-resolution logo to irmgolf@indstate.edu

Would your company be interested in donating a large prize for the IRM raffle/drawing the day of the outing?

(i.e. - television, golf bag, golf club or clubs, tickets to sporting event, etc.)

Yes, the large item our company would like to donate is:
No thanks, not this time

Would your company be interested in donating 150 smaller items to be included in each golfer's gift bag for the day of the outing? (i.e. - golf hats, towels, tees, T-shirts, divet fixers, ball markers, etc.)

Yes, we will be sending the following:
No thanks, not this time

Do you have another friend or colleague that you would like to receive information about our outings in the future? If so, please list his/her name and contact information here: (if more than one, please use "Other Comments" field at bottom)

Name:
Company:
Address:
City, State, Zip:
Phone:
Email:

Which category(ies) best describes you?

Scott College of Business alumnus/na
ISU alumnus/na from area other than Scott College of Business (include ISU college/degree below):
Community member
Friend or Supporter of the Scott College of Business
ISU faculty or staff
Parent of ISU student

Other comments?