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Berkshire Hills Country Club

Friends of Mark Belanger

June 6th

ENTRANCE FEE: $80 Per Team

Name __________________________________________________________________

Address ________________________________________________________________

City _________________________________State ______________Zip _____________

Home Course _________________________Handicap ________        GHIN #   _______

Partner's Name ___________________________________________________________

Home Course _________________________Handicap ________        GHIN #   _______

Reserve the following:   ___________Additional Meal (s)      --- $18.00

Cart Yes (       )  No (      ) --- $28.00

Please make check payable to Friends of Mark Belanger or Al Belanger

Return to the Pro Shop - Berkshire Hills Country Club

OR

Mail to: Al Belanger         Phone (413) 442-6661

             118 Wealthy Ave

             Pittsfield, MA 01201