Name : ________________________________NTRP:_______
Phone: __________________ Cell/work:
________________
Partner : ______________________________NTRP:_______
Phone: __________________ Cell/work:
________________
Check level: o 6.0 o 7.0 o 8.0
o 8.5
Entry
Fee:
$_________ $30 per person / $60 per team
$_________ Additional donation to HABIC
(optional) is Tax Deductable
$_________ Total Amount Enclosed
Make Check Payable to: HABIC
- CSU Foundation
