Esports Interest Form

Student Information

*Name:

Address:

City:

State:
- Select - Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

ZIP Code:

*Email Address:

Phone Number:

High School Graduation Year:

Intended Entry Type:
- Select - First-time Freshman Transfer Student

Athlete Information

*Are you interested in Competitive, Club, or Casual opportunities?

*Are you interested in applied learning opportunities? (Video editing, graphic design, shoutcasting, etc)

*Games Played or Roles interested in:

Current Rank (if applicable):

Social Links (Twitter, Twitch, Discord ID):

Any additional information you would like to share?