Midland University Powerlifting Interest Form

Powerlifting Interest Form

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

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

Raw Equipped
Best Squat
lbs
Best Bench
lbs
Best Deadlift
lbs
Gender *

Male Female
USAPL Membership Number
If you have a USAPL Membership
Should be Empty: