Hospice of Frederick County

Hospice of Frederick Co.
A Division of Frederick Memorial Hospital

Thank you for supporting the 7th Annual HFC/FMH Golf Classic. A benefit for Hospice of Frederick County, A Division of Frederick Memorial Healthcare System. Your participation enables us to continue to provide high quality hospice care to our community. We hope you enjoy your day and we look forward to seeing you again next year!

Although not all fields are required we ask that you please fill out as much of this form as possible. Thank you.

* = Required

* Name:

Company:

* Address:

City:

* State:

* Zip:

E-mail:

* Telephone Number: 410-123-1234

Fax Number: 410-123-1234

Would you like to be placed in a foursome, or will your foursome be accompanying you:

Name your Foursome

Name:

Shoe Size:

Name:

Shirt Size:

Name:

Shirt Size:

Name:

Shirt Size:

Glove Size:

Select your level of sponsorship:

Sorry I can't participate, however I'm mailing a contribution to Hospice of Fredrick County in the amount of: $

I/we would like to provide a gift certificate or item for prize drawing or silent auction. Please mail item or deliver to Hospice of Frederick Co.

Please provide disk or camera ready artwork by August 1, 2002

Please make check payable to: Hospice of Frederick County
Mail to: Hospice of Frederick County
P.O. Box 1799
Frederick, MD 21702

For more information call 301-698-3036
Email: lchole@fmh.org
Gifts are tax deductible in accordance with the Internal Revenue Code.
For details call Hospice of Frederick County at 301-698-3030