Please fill out all of the fields in this questionnaire. If any of the fields is not applicable, put in "N\A." Thank you for taking the time to fill out this form
Eric Seremet Head Lacrosse Coach
General Information
Are you an alum or friend of the program?
Alum Friend
Last Name:
First Name:
Graduation Year:
Years Competed in Lacrosse (i.e. 2000, 01, 02):
Contact Information
Personal Email Address:
Work Email Address:
Preferable email address to receive correspondence:
Personal Work
Is it permissible to list your name and email address on the lacrosse alumni page?
Yes No
Home Street Address:
City:
State:
Zip Code:
Telephone #
Career/Family Information
Current Rank (if still in USAF):
Current AF Base (if still in USAF):
Current Job (Brief Description):
Current Company or Institution (if not in USAF):
Spouse's Name:
Child(ren)'s Name(s)
Child(ren)'s Age(s)
Are you interested in joining a "booster club" specific to lacrosse?
Please list here any other comments you would like to make:
You will be re-directed to the Lacrosse Home Page upon submission of the form.