Player Scholarship Form

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Email *

Club *

What is the name of player that you are requesting scholarship reimbursement? *

What is the player's USA Lacrosse Membership Number (if known)? *

Please acknowledge that the player indicated above will be rostered on a team that is registered to play games with in the NCJLA. The NCJLA will verify that the player has been rostered on an NCJLA team by March 1st. *

I acknowledge the above.

Required

Division in which the player will be registered? *

Girls

Boys

Required

Age division in which the player will be registered? *

Level of Play in which the player will be registered? *

Name of the team in which the player will be registered? (ex. Malibu Pink Flamingos G12B Rookie) *

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