| 2008-2009 |
| LVCA Membership Application |
| Please type and then print |
| Last Name: | ||
| First Name: | ||
| School: | ||
| Title: | ||
| Division:
MEMBERSHIP AFFILIATION (Please Check One): ____ Head High School Coach, _____ Assistant High School Coach, _____ Jr. High Coach, ____ University Coach, ____ Jr. High Coach, ____ Club Coach Only, or ______ No longer coaching
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ALL MEMBERS, NEW OR RETURNING, MUST COMPLETE THIS INFORMATION |
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| School Address: |
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| City: State: , Zip: | ||
| School Phone Number: -- your extension | ||
| Home Address: | ||
| City: State: , Zip: | ||
| Home Phone Number: -- | ||
| Cell Phone (optional): -- | ||
| E-mail Address: | ||
| Date of Birth: | ||
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MEMBERSHIP FEES |
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| MEMBERSHIP FEES (Please Select one) | ||
| Please send my LVCA Correspondence | ||
| Home | ||
| School | ||
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Amount Included $ |
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Make checks payable to LVCA |
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| Completed application and check MUST be POSTMARKED BY SEPTEMBER 29, 2008 to: | ||
| Sam Houston Volleyball | ||
| s/o Rene' Fontenot | ||
| 880 S. Houston Jones Pky | ||
| Lake Charles, La 70611 | ||
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