Esports Recruiting Form

Email Secondary Email

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Email address *

First name *

Last name *

Address 1 *

Address 2

City *

State *

ZIP Code *

Cell Phone Number *

Discord Username *

Date of Birth *

mm/dd/yyyy

Game of Interest *

Ranking in Game of Interest *

Anticipated College Major *

High School *

Year of Graduation *

High School

Additional Comments

* required field