Home Form DMU Golf Benefit Sponsorship DMU Golf Benefit Sponsorship Is this sponsorship for an individual or an organization?*IndividualOrganizationName* First Last OrganizationPlease list as you want printed for promotional purposes.Email* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Do you plan on golfing?*Will be golfingSponsorship onlySupport level*Eagle Sponsor ($5,000)Birdie Sponsor ($2,500)Par Sponsor ($1,500)Bogey Sponsor ($1,000)Foursome ($800)3 golfers ($600)2 golfers ($400)1 golfer ($200)1 student golfer ($50)Support level*Eagle Sponsor ($5,000)Birdie Sponsor ($2,500)Par Sponsor ($1,500)Bogey Sponsor ($1,000)Foursome ($800)3 golfers ($600)2 golfers ($400)1 golfer ($200)Other amountOther amount* Program*Doctor of Osteopathic MedicineDoctor of Physical TherapyDoctor of Podiatric MedicineMaster of Health Care AdministrationMaster of Public HealthMaster of Science in AnatomyMaster of Science in Biomedical SciencesMaster of Science in Physician Assistant StudiesPost-professional Doctor of Physical TherapyClass year*Golf groupIf you do not have a complete foursome we will assign golfers to your group.Please list all golfer(s) included with this registrationFirst nameLast nameEmailPhone If you would like to golf with others not included in this registration please list them below:First nameLast nameEmail (optional)Phone (optional) PaymentCredit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20152016201720182019202020212022202320242025202620272028202920302031203220332034 Expiration Date Security Code Cardholder Name Total $0.00 Comments Tax informationFor income tax purposes, the fair market value is $75 per individual. Your tax deductible contribution is $125 per individual. Des Moines University – Osteopathic Medical Center is a 501(c)(3) organization.