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
Division
Best Squat
lbs
Best Bench
lbs
Best Deadlift
lbs
Gender
USAPL Membership Number
If you have a USAPL Membership
Should be Empty: