2014 Golf Outing Registration Form

Sponsor the RJR Golf Outing • Register via mail or online at http://birdeasepro.com/RJRmemorial • _________________________________ • Business Name • _________________________________ • Contact • _________________________________ • Address • _________________________________ • City, State and Zip • _________________________________ • Phone • _________________________________ • Email Address • _________________________________ • Web Site • Sponsor Options: • Tee or Green $ 200 • Silver Sponsor $ 300 • Gold Sponsor $ 500 • Total Enclosed: $ • Please make all donations payable to: • RJR Memorial Fund, Inc • P.O. Box 403 • Pine Island, NY 10969 Deadline: June 20, 2014 • Information • RJR Memorial Fund, Inc • Board of Directors • Katie Rudy, President • Gary Rudy, Vice President • Catherine Rudy, Vice President • Tiffany Glavan, Secretary/Treasurer • Peter Tomczak • Nick Schirripa • John SchamarekJr • Doug Tornello • Dan Nagy • Contact Us • Email:RJRmemorialcarshow@ • hotmail.com • Facebook: Richard Jacob Rudy • Memorial Fund • Web site: www.RJRmemorialfund.org • Online Golf Outing Registration: http://birdeasepro.com/RJRmemorial • For additional information on the • Richard Jacob Rudy Memorial Fund • or the 2014 Golf Outing call • Katie 845-987-0797 or • Peter 845-699-0276 2014 Golf Outing Registration Form 4th Annual RJR Memorial Golf Outing Saturday June 28, 2014 at Great Gorge Golf Course 400 Route 517 McAfee, NJ 07428 www.RJRmemorialfund.org

RJR Memorial Mission Statement The Richard Jacob Rudy Memorial Fund is a non-profit organization established in memory of Richard Jacob Rudy. The primary mission of the fund is to assist children & families in need, especially local families. These families often face illness and other hardships. We also support other local charities, such as the Brian Ahearn Children’s Fund and Make-A-Wish Foundation of the Hudson Valley. The RJR Memorial Fund also donates to the Orange-Ulster BOCES CTEC scholarship program. Scholarships are awarded annually to BOCES graduates from automotive technology programs. • Event Itinerary • Registration and Lunch • Shotgun Start • Dinner Buffet • Outing Fee Includes… • Green Fee • Golf Cart • Commemorative Gift • BBQ Lunch • Dinner • Award Ceremony • Give-Aways • NOTE: Dinner available to non-golfers for separate fee!! Reservation Form Must be received by June 20, 2014 (please call if later) Register ONLINE at http:// birdeasepro.com/RJRmemorial OR By Mail: Complete the following form and mail, along with CHECK (payable to the RJR Memorial Fund) Richard Jacob Rudy Memorial Fund PO Box 403 Pine Island, NY 10969 ______________________________________ Name & Phone _______________________________ $125.00 ______________________________________ Name & Phone _______________________________ $125.00 ______________________________________ Name & Phone _______________________________ $125.00 ______________________________________ Name & Phone _______________________________ $125.00 Subtotal: $ . 12:00 pm 2:00 pm 6:30 pm

2014 Golf Outing Registration Form

2014 Golf Outing Registration Form

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