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Event Registration

Esports Visit Day

First Name

Last Name

Email Address

Phone

Check if address is outside of U.S. or Canada

Cell Phone

Address Line1

Address Line2

City

State/Province

Postal Code

Foreign Address Line

Country

In-Game Name (IGN)

Discord Name

Esports Game

Esports Game If Other

Role (ex. Support, Duelist, Top Laner)

Peak Rank (Numeric, if available)

Guest Count (not including yourself)

Entry Term

Admit Type

Academic Level

Academic Program

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