Wisconsin State Championship Team Entry Form
Wisconsin Local League
*
GML
MALT
NCL
NEL
GLL
LAL
NTRP
*
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
9.5
Gender
*
Male
Female
Mixed
League
*
18 & Over
40 & Over
55 & Over
65 & Over
Mixed 18 & Over
Mixed 40 & Over
Combo
Mixed Combo
Lo Tri-Level
Mid Tri-Level
Tri-Level Mixed
USTA Team Number
*
WILL YOUR TEAM ADVANCE TO THE SECTIONAL CHAMPIONSHIP SHOULD THEY WIN THE STATE CHAMPIONSHIP?
Yes
No
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: