Midland University Powerlifting Interest Form

Powerlifting Interest Form

Please fill in the form below.
E-mail*
Name*

First NameLast Name
Phone Number*
Format: (000) 000-0000.
State
State of Residence
Year Starting College*
Body Weight*
Enter lbs
Weight Class
Choose closest Collegiate Wt Class
RawEquipped
Best Squat
lbs
Best Bench
lbs
Best Deadlift
lbs
MaleFemale
USAPL Membership Number
If you have a USAPL Membership
Should be Empty: