Please Note that submitting the Student Nomination Form does not imply that you will be invited to Lax Scout's Gold or Titanium profiles, nor does it imply that we will be able to observe, evaluate or scout you. The purpose of this form is simply to notify Lax Scout of your interest in being scouted. If our Scouts are able to watch you and feel that you meet our strict criteria, then you may be invited to join either our Gold or Titanium profiles. You will not receive a reply once this form is submitted, so please do not contact us regarding its status and please only submit once per year. Please understand that we receive an enormous number of nominations and are only able to follow up on a fraction of those that meet our criteria, but we do read them all and try to accommodate students as best we can. We greatly appreciate your understanding and interest in Lax Scout.

Student's Name:
Email Address:
Address:
City:
State:	Select one Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -- Canada -- Alberta British Columbia Manitoba New Brunswick Newfoundland (Labrador) NW Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon
Zip Code:
Phone Number:
How did you hear about us:	Select one Flyer Flyer from Great Atlantic Local Lacrosse Store Lax Scout Staff Sticker Great Atlantic Catalog Coach Friend Camp Promotional Event Ad in Inside Lacrosse Other Advertisement Surfing the web Search Engine E-mail Other
School or Club:
Coaches Name:
Primary Position:	Select a Position Attack Middie Long-Stick Middie Defense Goalie
Graduation Year:	Select a Year 2007 2008 2009
Height / Weight:	ft.   in. /    lbs.
40-yd Sprint Time:
List the camps you have attended:
List your recent lacrosse stats:
List all your lacrosse honors and awards:
Explain why we should scout you:
If you do not live in the states listed above, what camps or tournaments will you be attending (when and where):
Additional Comments:
By clicking the submit button, you acknowledge that you are only supplying us with your information in order to notify us of your interest in our Gold or Titanium profiles. In no way does submitting this form imply that Lax Scout will invite you to either our Gold or Titanium profiles.