Mott Golf Classic Monday, June 1, 2015 Registration Form Due by May 1, 2015 Company Name of Contact Address Phone Fax Website Address Email Sponsorship Level      Presenting Sponsor - $50,000 Premiere Sponsor - $25,000 Major Sponsor - $12,000 Supporting Sponsor - $6,000 Contributing Sponsor - $3,000 (Charitable contribution: 90% -- Tax ID # 38-6006309) Payment Information Make checks payable to C.S. Mott Children’s Hospital Mail to: Sandra Knight University of Michigan C.S. Mott Children’s Hospital Administration 300 N. Ingalls, Room 4D02 Ann Arbor, MI 48109-5475 (fax) 734-936-0151 (phone) 734-763-9370 [email protected]  Payment enclosed  Bill me  Charge (please circle one): Card Number Discover Visa Exp. Date Mastercard American Express Signature Mott Golf Classic Monday, June 1, 2015 Golfer Registration Form Name of Company: Presenting Sponsor 16 spots Premiere Sponsor 12 spots Major Sponsor 8 spots Supporting Sponsor 4 spots Contributing Sponsor 2 spots Donate Spots