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Longest Day of Golf Pledge Form

June 29, 2009

This event will take place at Green Acres Country Club in Northbrook, Illinois.  All proceeds will fund a research project that will repurpose an existing drug(s) to create a new treatment for prostate cancer. Please fill out the pledge form below and we will contact you for your payment information when the event is over.


Golfer's Name*
Your Name*
$ Flat donation
$ Amount per hole
$ Amount per par
$ Amount per birdie
$ Amount per eagle
$ Amount per hole-in-one
$ Amount per stroke
Phone Number*
Email Address*
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