Forms; 1st Annual John D. Buskirk Memorial Golf Outing

1st Annual John D. Buskirk Memorial Golf Outing

Saturday June 12, 2010, 1pm at Harbor Golf Course,4338 Lake Road, Ashtabula, Ohio 44004

18 Hole 4 Man Scramble

$75 per golfer (fee includes 18 holes w/cart)

T-Bone Steak Dinner/Drinks/Prizes immediately after, Dinner to be held at

 Fraternal Order of Eagles, 120 Depot St., Geneva, Ohio 44041

Dinner Only Tickets $20

Proceeds will benefit a Scholarship Fund at John’s alma maters:Assumption Elementary School & Sts. John and Paul High School 

Please make checks payable to: John D. Buskirk Memorial Scholarship Fund

Phone 440-344-4465 or Email billbuskirk2003@yahoo.com

Please mail checks and forms to P.O. Box 348, Geneva, Ohio 44041

Name________________________________________

Address______________________________________

Email________________________________________

Phone________________________________________

player 1_____________________________________

player 2_____________________________________

player 3_____________________________________

player 4_____________________________________

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