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SPONSOR INFORMATION Company : ________________________________ Contact:_______________________

2014 KARL STORZ 4 th Annual Golf Tournament Supporting Dana Farber Cancer Institute. SPONSOR INFORMATION Company : ________________________________ Contact:_______________________ Phone/Fax#: ______________________________ Email:_________________________

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SPONSOR INFORMATION Company : ________________________________ Contact:_______________________

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  1. 2014 KARL STORZ 4th Annual Golf Tournament Supporting Dana Farber Cancer Institute • SPONSOR INFORMATION • Company: ________________________________ Contact:_______________________ • Phone/Fax#: ______________________________ Email:_________________________ • Mailing Address: ________________________________________________ • BRONZE Sponsor - $100 • 1 Sponsored Hole • SILVER Sponsor - $300 • 1 Sponsored Hole • A Team of 4 wears tournament shirt with your logo on the back • (Logo & payment needed by MAY 23rd ) • GOLD Sponsor - $750 (Please fill out back for Team name & players) • 4 Sponsored Holes • Assemble 1 Foursome to play • A Team of 4 wears tournament shirt with your logo on the back • (Logo & payment needed by MAY 23rd) • Other Donation: • Check _____________($ amount) • Gift Item for Raffle____________________ • (gift cards are welcome) • QUESTIONS: Jenn Cote Jennifer.cote@karlstorz.com • Gary Veber Gary.veber@karlstorz.com KINDLY MAKE YOUR CHECKS PAYABLE TO: KARL STORZ PLEASE RETURN THIS FORM NO LATER THAN MAY 23RD with payment : KARL STORZ Endovision C/O Jenn Cote – Exec. Admin.Assistant 91 Carpenter Hill Road Charlton, MA 01507

  2. Team Info TEAM NAME: _______________________________________ PLAYER #1: _________________________________________ PLAYER #2: _________________________________________ PLAYER #3: __________________________________________ PLAYER #4: _________________________________________ *Below for KARL STORZ use only* KSE Golf Player credit goes to: __________________________________

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