Omega Psi Phi Fraternity, Inc. Beta Pi Chapter   PRESENTS   THE TENTH ANNUAL

            NAME:_____________________________________________________________________

            ADDRESS:__________________________________________________________________

            CITY:_____________________________________ STATE:_______ ZIP______________

            TELEPHONE: HOME_______________________ BUSINESS_______________________

            ______ I will participate in the golf tournament and I am returning this form along with
                            my greens fee of $50.00.

            ______ I would like to make a donation of $__________ and receive the advertising benefits
                            specified in the sponsor letter.

            Please complete this form and return to (make all checks payable to Omega Psi Phi Fraternity, Inc.):

            If you have any questions, please call Andre L. Daniels at (352) 284-1376

                                                                    Golf Tournament
                                                                    c/o Omega Psi Phi Fraternity, Inc.
                                                                    P. O. Box 143143
                                                                    Gainesville, FL 32614