Golf Registration

	2008 Registration
	2008 Outing Details
	2008 Sponsorship Opportunities
	2007 Slide Show
	Directions
	Contact Us

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Required fields

Contact Information (if different from golfer's information)


Contact First Name

Contact Last Name

Contact E-mail:

Golfer Registration Information

Golfer First Name

Golfer Last Name

Title

Company

Mailing Address

City

State / Province

Postal / Zip

Country

Phone:

Extension:

E-mail:

I would like to be a CORPORATE SPONSOR

PLATINUM — $6,500	GOLD — $4,500
SILVER — $2,500	BRONZE — $1,500

I would like to SPONSOR A PRIZE HOLE — $1,000
I would like to SPONSOR A NON-PRIZE HOLE — $750

I would like to participate as a GOLFER(s)
I would like to participate with a FOURSOME — $1,250
I would like to participate as a SINGLE — $375

I am not a golfer but want to attend the GRILL BUFFET AWARDS DINNER — $100
I cannot make the outing, but would like to send a CONTRIBUTION to benefit the
Lankenau Institute for Medical Research.
Amount $

Comments

*After submitting your information you will be contacted to get payment information and details.

<% else dim myEmail: Set myEmail = New Email dim msg msg = "The following information was entered in the GOLF REGISTRATION page:" + VbCrLf _ + "------------------------------------------------------------------" + VbCrLf _ + "Contact First name:" + request.form("contactfirst") + VbCrLf _ + "Contact Last name:" + request.form("contactlast") + VbCrLf _ + "Contact Email:" + request.form("contactemail") + VbCrLf _ + "First name:" + request.form("firstname") + VbCrLf _ + "Last Name:" + request.form("lastname") + VbCrLf _ + "title:" + request.form("title") + VbCrLf _ + "Company:" + request.form("company") + VbCrLf _ + "Address:" + request.form("addr1") + VbCrLf _ + "City:" + request.form("city") + VbCrLf _ + "State:" + request.form("state") + VbCrLf _ + "Zip:" + request.form("zip") + VbCrLf _ + "Country:" + request.form("country") + VbCrLf _ + "Telephone:" + request.form("telephone") + VbCrLf _ + "Extension:" + request.form("extension") + VbCrLf _ + "Email:" + request.form("email") + VbCrLf _ + "-------------------------------------" + VbCrLf _ + "I would like to be a CORPORATE SPONSOR:" + request.form("sponsor") + VbCrLf _ + VbCrLf _ + "I would like to: " + request.form("hole") + VbCrLf _ + VbCrLf _ + "-------------------------------------" + VbCrLf _ + "Golfer:" + request.form("golfer") + VbCrLf _ + VbCrLf _ + "Non-Golfer:" + request.form("nongolfer") + VbCrLf _ + "Amount:" + request.form("amount") + VbCrLf _ + "-------------------------------------" + VbCrLf _ + "Comments:" + request.form("Comments") + VbCrLf myEmail.from= "golf@pharmavoice.com" myEmail.recipients= "mwalsh@pharmalinx.com,epena@pharmalinx.com" myEmail.subject = "PharmaVOICE.COM - Golf Registration Information" myEmail.message = msg myEmail.mailType = "text" myEmail.send() 'send email to golfer myEmail.from= "support@pharmavoice.com" myEmail.recipients= request.form("email") myEmail.subject = "PharmaVOICE - Golf registration" myEmail.mailType = "text" myEmail.filters = "{fname}^" + request.form("firstname") myEmail.messageLocation = "golf_registration_notification.txt" myEmail.send() 'send email to contact myEmail.from= "support@pharmavoice.com" myEmail.recipients= request.form("contactemail") myEmail.subject = "PharmaVOICE - Golf registration" myEmail.mailType = "text" myEmail.filters = "{fname}^" + request.form("contactfirst") myEmail.messageLocation = "golf_contact.txt" myEmail.send() set myEmail = nothing %>

Thank you for your participation!

Your information has been submitted and you will soon be contacted to get payment information and details.

See you on September 19, 2005!

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