North Dakota Open

 Aug 27-29, 2010

Entry Form

Name:_____________________________________________

Address:___________________________________________

City: ___________________________________ State:____________ Zip:________

Phone:_______________________

Email Address:______________________________________

Social Security Number: ______________________________

Professional Entry Fee: $750

INCLUDES PRACTICE ROUND, FOOD, SPECIAL EVENTS, GREEN FEES, PRIZES, AND RANGE

Check_____Cash______

Payment Method:  Credit Card ___MC___Visa____Check

Credit Card#______________________________

After August 15th, professional participant refunds will be issued less $100 administration fee.

Send Entry To:

Fargo Country Club Golf Shop

Attn: North Dakota Open Registration

509 26th Ave S

Fargo, ND 58103

701-237-6746