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
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