Phillips Exeter Academy
Lacrosse Information Sheet

The lacrosse coaching staff at Phillips Exeter Academy is pleased that you are interested in our wonderful school, and in participating in the lacrosse program. To help us get to know you a little better, would you please take a few minutes to fill out the information sheet below

Player Information (** denotes required field)
**Name:
**Address:
**State, Zip Code:
**Phone:
**Email:
Height:		Weight:
Birthdate:
School:		CurrentGrade:
Grade you would be entering at Exeter:
Coaching Information
Lacrosse Coach (most recent)
Name:		HomePhone
email:		Work phone
Other Coach (if applicable)
Name:		Phone Nos.:
Postion(s):
Describe your lacrosse experience below:
What other sports, (if any), do you play at a competitive level?
Any Additional Information (e.g. Academic grades, scores, awards, etc..)

For Phone or Mail Inquiries Contact:

Mr. Eric Bergofsky
Varsity Lacrosse Coach
Phillips Exeter Academy
20 Main St.
Exeter, NH 03833

School Phone - 603-777-3755
Home Phone - 603-772-2492
Fax 603-777-4384
e-mail ebergofsky@exeter.edu