GREG CANNELLA’S ALL-STAR LACROSSE SCHOOL July 6-9, 2008 cannella@admin.umass.edu (413) 545-3782

Application Form
First Name:	___________________________________________________
Last Name:	___________________________________________________
Address:	___________________________________________________
City/State/Zip:	___________________________________________________
Telephone:	___________________________________________________
E-Mail Address:	___________________________________________________
Grade Entering Fall of 2008:	________________________
Position:	________________________
Short size:	Adult sizes: S   M   L   XL    (circle one)
Roommate Preference: (list one - only 2 in a room)	___________________________________________________
Date:	________________________
Print Full Name:	___________________________________________________
Tuition:	July 6-9, 2008 $480.00 Deposit (non-refundable) $200.00 Total Amount Enclosed: $__________________

Make checks payable to:	Greg Cannella’s All-Star Lacrosse School and print player’s name on your check.
Mail to:	Greg Cannella’s All-Star Lacrosse School 287 River Drive Hadley, MA 01035
Additional information will be sent upon receipt of application and payment.
Office Use Only:	Initial Date Rec CH # AMT Bal Due                         Med/Imm Form Rec On: ____________________