1. 6th Annual VPPPA Region VII Scholarship Golf Tournament Monday May 6, 2013 8:00 am Tiffany Greens Golf Course 5900 NW Tiffany Springs Parkway; Kansas City, MO (816) 880-9600 6th Annual VPPPA Region VII Scholarship Golf Tournament Monday May 6, 2013 TOURNAMENT FORMAT 4 Person Scramble Shotgun Start 8:00 am Registration begins 7:00 am - On Course events: hole-in-one, closest to the pin, longest drive, longest putt - Tournament Awards: 15 minutes after golfers finished playing ENTRY Entry fees are $75 per player or $300 per team. This fee includes green fees, carts and tee package. Singles will be matched with teams by draw. Payment methods include check or credit card (see the registration form on reverse side). Completed golf registration forms and fees should be submitted by April 23, 2013. Registration cannot be accepted without payment. INCLEMENT WEATHER In the event of inclement weather, prizes will be awarded by drawing at the banquet. Since this is a charity event, registration fees and sponsorships are non-refundable. Tiffany Greens Golf Course will make every effort to hold the event, including an abbreviated format. Only under severe weather conditions will play not be allowed. The VPPPA Region VII is a 501(c)(3) non- profit organization. http://www.tiffanygreensgolf.com/

2. THE 6th ANNUAL VPPPA Region VII Scholarship Golf Tournament May 6, 2013 Shot Gun Start 8:00 am REGISTRATION FORM Primary Company Sponsor ______________________________________ Address ______________________________________________________ City/State/Zip __________________________________________________ E-Mail Address ________________________________________________ Daytime Phone ____________________________________________ Golfer Name : 1.___________________________________________________ 2. ___________________________________________________ 3. ___________________________________________________ 4. ___________________________________________________  YES I would like to play but need help with a team $75 per player or $300 per team We hope you will be able to select one of the sponsorship contribution options.  YES I would like to Sponsor Check Sponsorship Level  Master Sponsor $400  Open Sponsor $200 4 Golfers 2 Golfers 2 Tee Signs 1 Tee Sign  Hole Sponsor $125  Tee Sponsor $50 1 Golfer 1 Tee Sign 1 Tee Sign  I am unable to play, but enclosed is a donation for the VPPPA Region VII Scholarship Fund in the amount of $______________. Total Registration fees $___________________ Method of Payment (check appropriate box)  Check Payable to: VPPPA Region VII Scholarship Golf Tournament Credit Card  MasterCard  Visa  American Express ____________________________________________ Card Number _________________________________________________ Cardholder Name (print) ___________________________________________ Expiration Date _____________________________________________ Cardholder Signature If paying by check, completed registration form with check should be mailed by April 23, 2013 to: VPPPA Region VII Address If paying by credit card, completed registration form, along with credit card information requested above, should be sent by April 23, 2013 to: Carlena Ford Phone: (703) 761-1146 ext. 304 Fax: (703) 761-2194 Email: cford@vpppa.org The VPPPA Region VII is a 501(c)(3) non-profit organization. Tiffany Greens Golf Course 5900 NW Tiffany Springs Parkway; Kansas City, MO (816) 880-9600 http://www.tiffanygreensgolf.com/

3. TIFFANY GREENS