Entry Form ..................... Schedule of Events

Cosmo Knights
Club, Inc.
Established 1949
Cosmo Knights Club, Inc. Membership
Officers:
Chairman of the Board: Lacy Johnson
President: Russell Gilliam
Vice President: James Zore
Secretary: Kevin Robinson
Assistant Secretary: Charles Eberhardt
Financial Services Secretary: Michael Covington
Treasurer: William Berry
Parliamentarian: Joyce Rogers
Sargent at Arms: Mark "Tony" Duncan
Al King
Gerald Kosene
Alan Mills
Al Oak
Sam Odle
Francis Parks
George Pillow
Greg Porter
Rod Ratcliff
Henry Robinson
Kevin Robinson
Joyce Rogers
Darrell Street
James Tucker
Steve Waugh
Val Zellers-Gleghorn
James Zore
William Berry
Claude Bibbs
James Correthes
Michael Covington
Rudolph Cumberlander
Terri Czajka
Bill Dahm
Carl Drummer
Tony Duncan
Charles Eberhardt
Dave Ford
Russell Giliam
Lisa Glenn
Monroe Gray
Thomas Hanify
Charles (Darrell) Henry
Lacy Johnson
Lacy Johnson III
Emeritus Members:
Oswald Parks
Charlie Smith
Carl Rice
Entry Form
.....................
Register online at:
Friday, July 10th
CosmoKnightsGolfOuting2015.eventbrite.com
Scramble
18-Hole Tournament
(Please enter early to ensure your participation)
$125.00 entry fee per person
$500.00 entry fee per Team of 4
Street: ________________________ Zip: ___________
at Eagle Creek Sycamore Course
9am: Sign in
8am-9:30am Hospitality and Registration
-Free Range Balls before 10:30am
-Cart Assignments, final registration
-Box Lunch Provided
10am: Shotgun Start
Members:
William Crain
Johnny Curtis
Charles Griffin
Lenny Irons
Schedule of Events
.....................
Free Reception & Hospitality
6pm–10pm: Cosmo Knights Club
3338 N. Illinois St. Indianapolis, Indiana 46208
*You and/or your team will be disqualified if you miss
the shotgun start.
For more information please contact a
member of the Planning Committee
Chairman Lacy Johnson:
Vice Chairman Charles Eberhardt: 317-513-5212
Vice Chairman & Event Manager
Michael Covington:
317-506-7214
James Minor:
317-250-0393
Francis Parks:
317-441-5073
Russell Gilliam:
317-331-0551
Lenny Irons:
317-440-1835
Name: ______________________________________
Address: _____________________________________
City: _________________________________________
Phone: ______________________________________
Email: _______________________________________
(Pick 1)
 Individual Registration
 4 Team Registration
Indicate if you are registering as an individual
or if you are registering a 4 person team. If you
are registering a 4 person team please list the
names of the 4 individuals below:
(A) __________________________________________
(B) __________________________________________
(C) __________________________________________
(D) __________________________________________
Personal Checks, accepted through July 1st.
Only Cash, Cashier’s Checks and Money
Orders are accepted after July 1st.
Charitable Donation - No Refunds.
Mail to:
Cosmo Knights Scholarship Fund, Inc.
Scholarship Golf Outing
3338 N. Illinois Street
Indianapolis, IN 46244
Cosmo Knights Scholarship Fund, Inc.
3338 N. Illinois Street
Indianapolis, IN 46208