GM iMR Hole-in-One Application Form

Hole-in-One Insurance Application

800-465-3461 : Fax: 770-534-2233 : golf@tsisports.com
Dealer Name:*
Contact Name:*
E-mail:*
Phone:*
Fax:
Dealer Location

Street Address

Street Address Line 2

CityState

Zip Code
GM Car Line:
BAC Number:
Dealer Code:
Golf Course:
Event Name:
Event Date:

MonthDayYear
Date
End (If Multiple Days):

MonthDayYear
Date
Hole #
Yards
Amateurs
Prize Description
Prize Value
Charge to Dealer Account:

GM iMR (Co-op)BARS (No Co-op)No
A contract will be emailed or faxed to the client. The contract should be checked for accuracy, signed and emailed or faxed back to TSI Sports. Payments not charged to valid GM Dealer Accounts must be postmarked prior to the day of the tournament. Additional program details are at gmhio.com. For more information:
Call 800-Hole-in-1 (800-465-3461), Email golf@tsisports.com or Fax to 770-534-2233.

Turnkey Co-op Hole-in-One services are authorized by General Motors LLC.
Should be Empty: