Yardley Country Club Golf Tournament Registration 2019 Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone number*Email* Golf Event Tickets – $125 Price: $125.00 Number of Golf Event TicketsNames of Golfers* Dinner Only – $40.00 Price: $40.00 Number of Dinner AttendeesNames of Dinner Attendees* Golf Sponsorships:Email Sue Malone at suebobmalone@gmail.com to submit your logo to be displayed during the golf outing. Also, it is required to list all golfers playing under the sponsorship.Eagle Sponsor: $2,000 includes 2 foursomes and cart signage Price: $2,000.00 QuantityNames of All Golfers* Birdie Sponsor: $1,500 includes 2 foursomes and 9 tee signs Price: $1,500.00 QuantityNames of All Golfers* Par Sponsor: $800 includes 1 foursome and 4 tee signs Price: $800.00 QuantityNames of All Golfers* Golf Donations:Tee or Green Signage for Business Sponsor or Loved One Sponsor. $75.00 Donation Price: $75.00 QuantityFairway Donation: Donate to our Raffle Drawings Golf related items; Sports memorabilia, Wine or Liquor, Baskets, electronics, jewelry OR use your imagination!!! If donating a gift, please contact Sue Malone at 215-295-2387 or suebobmalone@gmail.comGeneral Donations$25 Donation$50 Donation$75 Donation$100 Donation$150 Donation$200 DonationOther Donation AmountOther Donation AmountEnter your donation amount With your $75.00 donation you can display a business logo or picture of a loved one or share a special message. Email this information to Sue Malone at suebobmalone@gmail.comTotal $0.00 Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name