Professional Entry Application
2010 Camp Foster Pro-Am
Emerald Hills GC
Tuesday, July 13
Entry Deadline: July 6
Name: ____________________________________________
Address:___________________________________________
City: _________________ State: ______
Zip: _________
Phone:______________
Cell Phone:___________
Social Security #:____________________________
Email______________________________________
Entry Fee _$150.00
Payment Type: ____Check ____Money Order ____C.C. *
*Credit Card Information (Visa, Mastercard, or American Express):
Name on Account:________________
Type of Card:___________________
Card Account #:__________________
Expiration Date:__________________
Send or Fax entry to:
Randy Rohlfsen,
PO. Box 60
Hwy. 71
South Arnolds Park, IA 51331
712 332-7100