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Please note any golf card orders placed after 4:00 PM December 20 will not be processed until after the holidays. Thank you. If you need a card for Christmas after that date please visit one of our member courses or vendors (Price Chopper or Northway 8 Golf) to get a card.

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Billing Address:

First Name:

Last Name:

Address:

City:

State:

Zip:

Phone:

Fax:

Email:

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Is the Shipping Address the same as the Billing Address above?

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Shipping Address:

First Name:

Last Name:

Address:

City:

State:

Zip:

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Quantity of Golf Cards:

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Payment Information:

Card Holder Name:

Credit Card Number:

Exp. Date:

CIN Number (3 digit number on back of card for VISA/Mastercard or 4 digit number on front of card for AMEX):

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Type of Credit Card:

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Credit Card Billing Information:

Address:

City:

State:

Zip:

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How did you hear about the Capital Region Golf Card?

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Who did you purchase the Capital Region Golf Card for?

Yourself

Gift