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New York State Deputies 2019 Celebrity Golf Classic

Name _____________________ Company _____________________

Address ___________________ City _________________________

State __________ Zip ________ Phone _______________________

Email _____________________


(1)______________________ (2) _________________________

(3)______________________ (4) _________________________

___ Deputy $550.00

___ Sheriff $650.00

Sponsorship Package:

___ Tee/Green $100.00

___ Foursome $500.00

___ Single Golfer $125.00

Early Bird Registration $110.00 single, $440.00 foursome

Enclosed is payment in full for $______________

I would like to donate a prize or auction item _____________________

I would like to sponsor a Tee/Green for $100.00

Please make checks out to NYSDA

Payments may be mailed to: NYSDA C/O Norman Itjen

PO Box 412, Elba NY 14058

Any questions feel free to contact:

Norman Itjen @ (585) 409-4540 email

Jeff Newman @ (716) 807-6270 email

Sat, June 1, 2019 11:00 AM – 5:00 PM EDT

Seneca Hickory Stick Golf Course 4560 Creek Rd Lewiston, NY 14092 United States

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