ESPORTS Prospect Form

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First Name: *

Last Name: *

Email address *

Address: *

City: *

State: *

Zip: *

I am a: *

If you are a CCC Student, what is your primary location? *

High School: *

Graduation Year: *

Games you play: *

What level of eSports are you interested in competing? *

Do you own a PC/Console: *

Yes No

If yes, identify what PC/Console you own:

Have you ever been on an eSports team or competed in an ESPORTS tournament? *

Yes No

Coach:

Coach email:

Coach Phone Number:

Have you ever streamed your gameplay or watched other people stream their gameplay (i.e. Twitter, Mixer, Facebook, YouTube, etc.) *

Yes No

If yes, please explain:

Video Link:

List highest matchmaking rank achieved within the games you play: (For example, Gold-Overwatch)

Athletic honors, Accomplishments, awards:

Comments:

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