Cycling Recruit Questionnaire
Email
Secondary Email
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Email address *
General
First Name *
Last Name: *
Home Address 1: *
Home Address 2:
City *
State *
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Outside U.S.
ZIP: *
Contact Phone #: *
Cell: *
Date of Birth: *
Date Picker
Background
Mother's Name
Mother's Phone
Mother's Email
Father's Name
Father's Phone
Father's Email
Siblings Name & Ages
Academic
High School Graduation Year *
High School Name *
High School Address *
Class Rank
High School GPA *
Other College Choices
Intended Major *
Athletic
USA Cycling License # (if applicable)
Height *
Primary Cycling Discipline *
Mountain, Road, etc.
# of Years Riding *
Do you have a Bike/Bikes *
Yes
No
Multiple Bikes
Top Five Racing Results
Why do you Ride/Race? *
Submit
* required field