Roster Summary Sheet Template Fy12
2
Arlington County Department of Parks, Recreation and Cultural Resources The Sports and Recreation Division 3700 South Four Mile Run Drive Arlington, Virginia 22206 703-228-1801 / 703-228-1825 ROSTER SUMMARY SHEET Organization Name: Arlington Youth Lacrosse Applicant Name: Jon Cunha Sport: Lacrosse Season: Spring 2014 Please provide information on the number of registered participants: Total Number of Players CALCULATION OF ASSESSMENT AGE PLAYERS TOTALS Female Male County ASSESSMENT 4 0 0 0 0 Per Participant 5 2 5 7 6 10 29 39 449 x $8.00 7 18 36 54 Total Participants 8 12 32 40 4 9 23 43 62 4 10 24 57 80 1 NON-COUNTY ASSESSMENT 11 26 34 60 12 17 31 48 9 x $20.00 13 17 27 44 14 1 13 14 15 3 1 TOTAL DUE TO ARLINGTON COUNTY 16 17 $3,772.00 18 Adults CHECKS MADE OUT TO: 150 310 449 9 TREASURER, ARLINGTON COUNTY Check No: Female Male Coed MAIL TO: 8 16 Number of Scholarships Provi 4 $ Amount of Scholarships Pro $ 760 $ www.arlingtonva.us/prcr Non- County TOTAL PLAYERS Total Number of Teams PRCR - (STAFF LIAISON NAME) 3700 S. FOUR MILE RUN DRIVE ARLINGTON, VA 22206
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Transcript of Roster Summary Sheet Template Fy12
Arlington County Department of Parks, Recreation and Cultural Resources (PRCR)The Sports and Recreation Division
3700 South Four Mile Run DriveArlington, Virginia 22206
703-228-1801 / 703-228-1825
ROSTER SUMMARY SHEET
Organization Name: Arlington Youth Lacrosse Club Applicant Name: Jon Cunha
Sport: Lacrosse Season: Spring 2014
Please provide information on the number of registered participants:
Total Number of Players CALCULATION OF ASSESSMENTAGE PLAYERS TOTALS
Female Male County ASSESSMENT4 0 0 0 0 Per Participant5 2 5 76 10 29 39 449 x $8.00 $3,592.00 7 18 36 54 Total Participants8 12 32 40 49 23 43 62 4
10 24 57 80 1 NON-COUNTY ASSESSMENT11 26 34 6012 17 31 48 9 x $20.00 $180.00 13 17 27 4414 1 13 1415 3 1 TOTAL DUE TO ARLINGTON COUNTY1617 $3,772.00 18
Adults CHECKS MADE OUT TO:
150 310 449 9 TREASURER, ARLINGTON COUNTYCheck No:
Female Male Coed MAIL TO:
8 16
Number of Scholarships Provide 4
$ Amount of Scholarships Provi $ 760 $
www.arlingtonva.us/prcr
Non-County
TOTAL PLAYERS
Total Number of
Teams
PRCR - (STAFF LIAISON NAME)3700 S. FOUR MILE RUN DRIVEARLINGTON, VA 22206
