ENTRY FORM

Amit Chokshi’s 36th Cypress Golf Club Invitational Golf Tournament
Sunday, June 12 and Monday, June 13, 2011
Edgewood Tahoe Golf Club, South Lake Tahoe

ENTRY DEADLINE: April 21, 2011

Your Name

Your E-Mail Address

Your Address
Street:

City, State, Zip Code:

Other Contact Information
Your Home Phone #:

Your Cell Phone #:

Your NCGA/SCGA Card #:

Current Index:

For Month (2009)
April:   May:

FEES (Please enclose your check for the amounts indicated):

t Male Entry: For 2 days of golf and cash awards

$400.00

t Lady Entry: For 2 days of golf (no prize fund)

$300.00

t For each entry, penalty of $45 if after April 21 and before June 1, 2011

$45.00 late entry penalty

TOTAL ENTRY FEES/PENALTIES ENCLOSED (Make check payable to Amit Chokshi)

Please complete this form, print it, and mail with your check to:
AMIT CHOKSHI
7284 VIA BREZZO
SAN JOSE, CA  95120

To print this form, right-click in it and select Print. Entry Form must reach Amit by April 21, 2011.