Professionals Entry Form

2010 Western ND Pro-Am
August 19-23
Contact: Todd H. Lee,
Minot Country Club, Box 250,
Burlington, ND 58722
Golf Shop Phone: (701) 839-6169

ENTRY FEE: $650
IF ENTRY FEE IS POSTMARKED BY AUGUST 1st - $625
SEND TO:
Todd H. Lee,
Minot Country Club,
Box 250, Burlington, ND 58722
Golf Shop Phone: (701) 839-6169

Player’s Name _____________________________________
PROFESSIONAL SOCIAL SECURITY NUMBER
_________________________________________________
Home Address _____________________________________
City______________________________________________

State________________ Zip Code_____________
Phone _________________

Email__________________
Best Pro Finishes___________________________________  _________________________________________________
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