PURCHASE INFORMATION
Business Name:
Contact: Title:
Street: City: State: Zip:
Phone: Fax: Email:
Toll Free: Website: Number of Holes:
Comments:
ANNUAL MEMBERSHIP DUES: (please select one)
Daily Fee 9 holes ($235)
Daily Fee 18 holes ($415)
Daily Fee 27 holes ($485)
Daily Fee 36 holes ($535)
Daily Fee 45 holes ($595)
Daily Fee 54 holes ($635)
Daily Fee 63 holes ($695)
Multiple Courses or Management Company ($795)

Corporate Michigan Member ($300)
PAYMENT INFORMATION
Check
Credit Card

John Dodge "Carpe Diem" Fund Voluntary Donation $
(Donations to the Fund are managed by the Educational Support Foundation 501(c) 3 for the purpose of awarding annual grants)