MARYLAND STATE SOCCER ASSOCIATION

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					        MARYLAND STATE SOCCER ASSOCIATION
               AFFILIATED WITH THE UNITED STATES SOCCER FEDERATION

                   MSSA CUP COMPETITION ENTRY FORM

Check one only:
     ROWLAND CUP - MSSA Men’s Open Cup                           $50
     STEWART CUP – MSSA Men’s Amateur Cup                        $50
     ROWLAND & STEWART CUPS                                      $80

Entry Fees for State Cups                                              $ _______________

Entry Fees for National Cups (must submit entry forms as well)      + $ _______________

Subtotal (Fees from State and National Cups)                           $ _______________

Performance Bond                                                    + $          100.00


TOTAL                                                                  $ _______________

Make check payable to the Maryland State Soccer Association.

DEADLINE: Saturday, December 1, 2001 - Entry forms and fees must be received by this
day.


Team Name: _________________________             League Affiliation: ____________________

Manager: ____________________________            Phone: _____________________________

Address: ____________________________            Fax: _______________________________

        ____________________________             E-mail: _____________________________

Field: ______________________________            Permit Authority: _____________________

Jersey: _____________________________            Alternate Jersey: _____________________

Shorts: _____________________________            Socks: _____________________________


SEND TO:             Anthony Falcone
                     5259 Ballycastle Circle
                     Alexandria, VA 22315-5501

				
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