July 30 - August 2, 2009The Ohio State University Golf Club, Scarlet Course

100% of Your Ticket Purchase Will Go to:

Charity Ticket Program

SHIPPING ADDRESS:

Name: ____________________________________________________________________________________ Company: _________________________________________________________________________________ Phone: _________________________ Email address: _________________________________ Address: __________________________________________________________________________________ City: __________________________ State: ____________ Zip: _____________

TICKET PRICES

Weekly (Grounds Access Thurs - Sun) $25 _____ Daily (One Day Grounds Access Thurs – Sun) $10 _____ Weekly 10-Pack ($50 Savings) $200 _____ Daily 10-Pack ($10 Savings) $90 _____

TOTAL

$_______

*Order by Phone by Calling Lisa Johnson at 614-339-1043 or Order Online beginning January 1, 2009 at www.nchigolf.com**Tickets will be Mailed Beginning in Mid-June*PAYMENT

Circle One: Credit CheckCredit Card #:___________________________ Circle One: VISA AMEX MasterCard DiscoverExpiration Date: _______ Security Code: _______ Please Send Forms and Make Checks Payable to:

Champions of the Community

6189 Memorial Dr.

Dublin, OH 43017*The Nationwide Children’s Hospital Invitational is Operated by Champions of the Community, a Non-Profit Organization

Recognized by the IRS as a Tax Exempt 501(c)3 Public Charity*