Midland University Powerlifting Interest Form

Powerlifting Interest Form

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

First NameLast Name
Phone Number*
State
State of Residence
Year Starting College*
Body Weight*
Enter lbs
Weight Class
Choose closest Collegiate Wt Class
Division*

RawEquipped
Best Squat
lbs
Best Bench
lbs
Best Deadlift
lbs
Gender*

MaleFemale
USAPL Membership Number
If you have a USAPL Membership
Should be Empty: