Avenues "Gorman Classic"

Yes, I(we) would like to participate in the July 21st, 2008
Avenues Gorman Classic

  Single Golf @ $475 each; or 8 or more registrations at $425 each

            tennis @ $200 each;

  dinner only @ $85 each;

            other;

          Please accept my contribution of

Thank you for your participation in the Avenues Classic event to support the programs of Avenues to Independence.  Please fill out the following information for acknowledgement and credit card transaction purposes only.  Avenues does not disclose this information to any third parties.

Total Amount:

Credit Card Type: Visa Master Card Discover

Card Number: 

Three digit security code
(on back of card in the signature box.  Usually shows xxxx   xxx  Put the last three digits in the above box)

Card Expiration Date: 

Name on Card: 

Please enter foursome, tennis and/or dinner guests names and any questions, special requests or other messages to Avenues:

If all information has been entered correctly, then you will see a confirmation page after you hit submit.  Contact us at:  847-292-0870 x 108 should you have questions regarding your credit card transaction.

All transactions are secured through the Network Solutions
SSL certificate for Avenues to Independence