COPPERBOWL QUALIFYING
APPLICATION
Deadline: December 15, 2007
MUST BE RECEIVED IN OFFICE BY DECEMBER 15, 2007
| Name (last) ______________________ |
|
(first _________________ |
| Address _____________________________________________________________________ |
| City ____________________________ |
State ____________ |
Zip __________________ |
| Home Phone __________________________ |
| Cell Phone __________________________ |
| Email ________________________________________________________________________ |
| Credit Card #(MC or Visa only)
______________________________ Exp _______________ |
| |
|
|
| Age Group(check one) |
|
|
| ____ Boys 18 |
____ Girls 18 |
| ____ Boys 16 |
____ Girls 16 |
| ____ Boys 14 |
____ Girls 14 |
| ____ Boys 12 |
____ Girls 12 |
| |
| Entry
Fees |
| ____ Qualifying singles: $40.00
(qualifiers will pay an additional $35.00 upon qualifying) |
| |
| Options for Entry |
Mail entry and fees to:
Dickinson Sports, LLC
9731 N. Cliff View Place,
Tucson, AZ 85704.
|
Fax
to:
520) 742-1709
(must have valid credit card # included) |
Call:
(520) 742-2204 #
Enter by phone with credit card |
| |
|
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|
Click here
for a printable Application Form
 Click
this image to download free Adobe Reader
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