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Plase complete the following application in it's entirety, double check your information and hit submit. You will then be contacted if selected. Good luck!
Name:
Nickname:
Age:
Address:
Phone Number:
Email Address:
Manager:
Manager Address:
Manager Phone Number:
Manager's Email:
Weight Class (Check One):
135
145
155
170
185
205
heavyweight
Height:
Conventional or Southpaw:
Name of Trainer:
Fight Team Name:
Fight Team that you will not compete against:
Training History: (300 characters)
Walk Out Song:
Artist:
Song Title:
Pro MMA Record:
Amateur MMA Record:
States you hold licenses in:
Please check off which medicals you have completed and the date they were last done:
DATE (ex.01/02/2006)
HIV Test
HEP B Surface AG & HEP AB testing, not vaccinated
Complete Blood Count (CBC) and Bleeding & Coagulation (PT/PTT Pro-time)
Original EKG report, read by a physician
Original CT/MRI Brain Scan report (without contrast), read by a physician
Original EYE examination by an ophthalmologist - ophthalmological dilation
Annual Physical/Clinical
List any titles you currently hold or have held in the past:
Click here to download this application
Click here to submit fighter photo
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