Macedonian Open Online Registration Form

Golf & Dinner $200 each No. of Tickets $
Junior 17 & Under $100 each No. of Tickets $
Hole Sponsor $300 each No. of Tickets $
           Total $
Please Calculate Your Total Before Continuing -->

Registrant Information
Name
Company
Street Address
Suite
City
Province
Country
Postal Code
Phone
E-mail
   
  Names of the Foursome
(if applicable)
  Player 1
  Name
    Macedonian Age Sex
    Yes
No

17&Under
 18 to 49
50 to 64
65 +

Male
Female
  Address
  Postal Code
  Phone
  Player 2
  Name
  Macedonian Age Sex
    Yes
No		 17&Under
 18 to 49
50 to 64
65 + 		Male
Female
  Address
  Postal Code
  Phone
  Player 3
  Name
  Macedonian Age Sex
    Yes
No		 17&Under
 18 to 49
50 to 64
65 + 		Male
Female
  Address
  Postal Code
  Phone
  Player 4
  Name
  Macedonian Age Sex
    Yes
No		 17&Under
 18 to 49
50 to 64
65 + 		Male
Female
  Address
  Postal Code
  Phone
   
Payment Information  
Your Total $
Payment Method
Credit Card No.
*Identification No.
 Card Expiry Date month   year
Cardholder's Name
Postal Code
from billing address

* The Card Identification Number (Card ID) is required for your Visa and MasterCard. The Card ID is an added security feature to help protect you against online fraud.

Visa and Mastercard
see the last 3 digits on back of card

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