Florida District Exchange Club Golf Social
Thursday, June 7, 2012
12:00 pm Shotgun Start
Isla Del Sol Golf & Country Club
6000 Sun Blvd.
St. Petersburg, FL 33715
$40.00 per Person
Name _________________________________________
Address________________________________________
Phone__________________________________________
E-Mail___________________________________________
Assign me with others: Yes __________ No ___________
Members in foursome______________________________
______________________________________________________________
Make checks payable to: FL District Exchange Club
Mail checks and registration forms to:
Amy Mueller, Registration Coordinator
Fax: 813-977-8271
5941 63rd Terr. North Credit Card Information: __ MC __ Visa __ AMEX Sec Code ____
Pinellas Park, FL 33781 Name: _____________________________________________
E-Mail: ammue@aol.com Credit Card Number:___________________________Exp. _________
Phone: 727-459-6726 Address: _________________________________________________
Phone: ___________________________________________________
Signature: ________________________________________________