Name _____________________________________________________Company _________________________________________________Address ___________________________________________________City ______________________________________________________State ___________________ Zip _____________________________Phone ____________________________________________________

Player #1 Name _____________________________________________Player #2 Name _____________________________________________Player #3 Name _____________________________________________Player #4 Name _____________________________________________

Method of Payment:o VISA | MASTERCARD | AMEX (Circle one)

o Check (payable to the Salem Educational Foundation)

Total Amount: $ ____________________________________________Credit Card # _______________________________________________Name on Card ______________________________________________3-Digit Security Code (on back of card) _____Expiration Date ____ /____Billing Address for Card o same as above Address ___________________________________________________City, State, Zip________________________________________________

Return this page of the brochure by October 14th to:Tracy Hale117 Sheraton DriveSalem, VA 24153 oror via email: tracyphale@gmail.com

November 2, 2013Hidden Valley Golf Course | 8am Breakfast | 9am Start

Golf Tournamentin memory ofJill Bailey Chenet

Information and Payment Form

Golf Tournamentin memory of Jill Bailey Chenet

Jill Bailey Chenet, a Salem High School graduate whose family resides in town, passed away in July 2012. She and her husband Matt were expecting their first child.

In her honor, we invite you to participate in a Golf Tournament raising funds for the newly established “Jill Bailey Chenet Scholarship Fund” which will also help raise funds for “Jill’s Buddy Camp,” a camp that matches teenagers with young developmentally delayed children.

Everything you need to knowF November 2, 2013F Hidden Valley Country ClubF Breakfast: 8:00 amF Shot Gun Start: 9:00amF $100 per GolferF $350 per TeamF Price includes player green fees,

cart and breakfast preceding playF $250 Hole SponsorF Make checks payable to:

Salem Education Foundation

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I am interested in participating in the:

Gold Package $1000 F Recognition as the Golf Tournament Sponsor

(to include signage provided by sponsor)F Team Golf PackageF A hole sponsor signF Acknowledgement in the event program

and at the dinner reception

Silver Package $600 F Two Golfer PackagesF Hole SponsorshipF Acknowledgement in the event program

and at the dinner reception. Team Package $350F Includes 4 golfer packages Individual Golfer Package $100 Hole Sponsorship $250F Businesses or individuals may sponsor a hole at the event.

Their name or message will appear on a tee sign and also in the dinner event program.