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Sponsor Name / Team Captain Name : __________________________________________

COLLEGE OF ANAESTHETISTS Fundraiser for Malawi GOLF CLASSIC & EDUCATION SEMINAR Elm Park Golf & Sports Club Ltd WEDNESDAY 1 ST OCTOBER 2008. Sponsor Name / Team Captain Name : __________________________________________ Address: __________________________________________

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Sponsor Name / Team Captain Name : __________________________________________

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  1. COLLEGE OF ANAESTHETISTSFundraiser for MalawiGOLF CLASSIC & EDUCATION SEMINARElm Park Golf & Sports Club Ltd WEDNESDAY 1ST OCTOBER 2008 Sponsor Name / Team Captain Name : __________________________________________ Address: __________________________________________ __________________________________________ Players Names Handicap • ___________________________________________________ • ___________________________________________________ • ___________________________________________________ • ___________________________________________________  I would like to enter a team of four Cost € 600.00 (Tee Times 8.00am – 10.30am and 2.00pm – 3.00pm) (Please contact us to determine what tee-off times are available)  I would like to attend the dinner & education seminar € 85.00 pp No: ---- individuals will attend the dinner total cost €________________ (Please indicate the total number of dinner attendees above)  I would like to sponsor a Golf Prize/ Raffle Prize € ________________  I would like to sponsor a tee box Cost €200.00  I would like to donate € _________________ Complete & return this form (available on our website www.anaesthesia.ie) with a cheque made payable to ‘College of Anaesthetists Education Fund’ and post to: Mary Malone Tel. 01 661 4412 College of Anaesthetists Fax 01 661 4374 22 Merrion Square North, Dublin 2 Email mmalone@coa.ie

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