Requested Registration for Monthly Meetings

»Request registration online using this form then contacting the person below in reference to payment;

»or register by printing this form, then completing and mailing it with payment to:

Diane Fischer
PMA Greater Missouri District
403 Droste Rd.
St. Charles, MO 63301
Phone: 314-550-5306
Fax: 636-916-3708
dianefischer5@yahoo.com

Please fill out this form for each person wishing to attend.

Requested Registration for the PMA/NTMA Golf Outing.

Company Information:
*Company
*Company Membership Status	Member Nonmember
*Company Address
Company Address
*Company City
*Company State/Province
*Company ZIP/Postal Code
*Company Country
*Company Phone
Company Fax
*E-mail
(A copy of this request for registration will be sent to the provided e-mail address. If you do not receive it within 24 hours, please contact Diane.)

Golfer Information:
Golfer #1
Name:
*Phone
*Handicap
Golfer #2:
Name
Phone
Handicap
Golfer #3
Name
Phone
Handicap
Golfer #4
Name
Phone
Handicap

Special Arrangements/Requirements