U-13 thrus U-19 play November 17th and 18th
Boys U-___
Girls U-___
Circle One: Competitive Intermediate
Team Name: ____________________________
Club:____________ League:______________ State Ass. :_________________
Coach:___________________ Asst Coach:___________________
Address:_____________________ Address:_____________________
____________________ ____________________
_________________ _______________
Phone:______________(Home) Phone:____________(Home)
______________(work)
_______________(work)
______________(fax)
_______________(fax)
Oldest Birthdate:___/___/19___ Youngest Birthdate: ___/___/19___
Prior Tournament Experience:
(Please list at least four)
Tournament:
Location:
Record:
Place:
Most Recent League Record:___________________________________________
Entry Fee: U-8 $120 U-9 thru u-19 $200
Please Print and send this application and entry fee payable to Gaylord Sheppard 2001 to the following address:
Beiglar Makvandi
9723 Menaul Blvd. NE
Albuquerque, NM 87112
For more info you can contact Beiglar Makvandi at:
505-271-1050(phone)
505-237-2396 (fax)
makva_b@yahoo.com/bmakva@aol.com (email)
Links
Duke City Soccer League
NMYSA
