UMSL Esports Interest Form

Personal Information

*First Name

Preferred First Name (Optional)

*Last Name

*Email Address

*Cell Phone

May we text you?

Yes

No

*Birthdate

Educational Information

*I am a:

First-Time College Student

Transfer Student

International First Time College Student

International Transfer Student

*Current or Most Recent School Attended

High School Graduation Date

CEEB Code (Hidden - Internal Only)

Current GPA

*I want to begin attending in:

*Academic Interest:

Inquiry Career (Hidden)

Gaming Information

*In-game Name

*Discord Handle

List Other Games Here

*Current Rank

Preferred Role or Favorite Team/Character

Competitive Esports Experience (if applicable)

Do you currently stream or create content?

Yes

No

Twitch/YouTube/Twitter Channel Link (if applicable)

In order to serve you better (send you printed material and other exciting communications) are you willing to provide us with more information?

Yes

No

Additional Contact Information

Mailing Address

Country

Street

City

Region

Postal Code

Parent/Guardian/Family First Name

Parent/Guardian/Family Last Name

Parent/Guardian/Family Email

hidden status of inquiry

Inquiry

University of Missouri-St. Louis

UMSL Esports Interest Form

Academic Units

Administration