| I would like to golf with |
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| *My shirt size is |
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| *My Shoe size is |
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| *Flight Preference |
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| *I am a member of Twenty Valley Golf and Country Club |
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| I understand that West Lincoln Memorial Hospital Foundation Inc. will keep the information I provide here confidential and agree that the Foundation may forward information or requests for donations in the future. |
| Additional Comments |
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| * Required Fields |
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