Date:			LaGrange Soccer Club Transaction Request
	Team:					PLEASE CIRCLE YOUR TEAM NAME AND BE SURE TO INCLUDE ALL INFO FOR DEPOSIT OR CHECK REQUESTS
				Deposit		Amount
	Blazers
	Chargers
	Cheetahs			New member registration
	Cougars			Fund Raising
	Eagles			Ad Book
	Falcons
	Freedom			Other: please explain
	Lightning
	Nightmares
	Panthers
	Phoenix
	Pride
	Red Devils ---u 23
	Red Fury
	Red Raiders
	Red Stars
	Scorpions
	Stingers
	Storm
	Strikers
	Thunder
	Tigers
	Titans
	United
	Vikings
	Check Request			Amount	Payable To	Address	Special Information
						for mailing
	Field/ Gym rental
	Tournament registration fees
	Uniforms
	Postage
	Trainers
	Travel Expenses
	Referee check *****
	Other : please explain