Parkinson's Disease Research Society

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PDRS - Treatment, Cure, Research, Education - Facing the challenge, finding the cure
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Par for Parkinson's Registration

All funds raised go toward Parkinson’s Disease Research

August 2nd, 2010
Glen Flora Country Club
2200 Sheridan Road Waukegan, IL
 Golf
*Indicates Required Field
  First Name: * Last Name: *
  Address: * City: *
  State: * Zip Code: *
  Email: * Phone:     *
 
 
  Golf & Dinner at $250 per Person. Number of Golfers: $  
 
Names of golfers in my group:

 
 
 
  Dinner Only at $100 per Person. Number of Dinners: $  
 
 
  Sponsor Holes at $300 per Hole. Number of Holes: $  
 
Please provide Sponsor Information you would like to appear on signs.
Sign 1:


 Sign 2:


 Sign 3:
 
 
 
  Raffle Tickets at $25 each or 5 for $100. Number of Tickets: $  
 
 
  I cannot attend but wish to contribute: $ Only Dollar Amounts Please. $  
 
 
  Total:  $  

You will be able to confirm your choices before payment.

Medical information on this website is not for diagnosis or treatment purposes.
Parkinson's Disease Research Society (PDRS)
Central DuPage Hospital		 Phone: 630-933-4384
Fax: 630-933-4380		 0N150 Winfield Rd., Suite A-2
Winfield, IL 60190