Midwest Combo Mixed Invitational Entry Form
Midwest District
*
CHI
NIL
MS
NIN
CIN
NEO
NWO
OV
SEMI
WMI
NMI
NEMI
WI
NTRP
*
5.5
6.5
7.5
8.5
9.5
Who will pay the entrance fee?
Fees are based on the number to teams advancing: (5.5 -$100, 6.5-$600, 7.5-$500, 8.5-$300, 9.5-Direct Advancement
USTA Team Number
*
Captain Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Captain Email Address
*
example@example.com
Cell Phone Number
*
-
Area Code
Phone Number
Captain E-Signature
*
Submit
Should be Empty: