FIGHTER’S APPLICATION
Complete the following application and press submit. You will receive a confirmation page asking you to submit a good picture of yourself for promotional purposes, please select the send picture button. You will be contacted once the application and picture have been received. If you prefer to print the application and mail it along with a picture, please click here to PRINT APPLICATION. Thank you!
FIRST NAME:
LAST NAME:
ADDRESS:
CITY:
DAY PHONE:
STATE:
CELL PHONE:
ZIP:
EMAIL:
AGE:
WEIGHT:
HEIGHT:
AMATEUR RECORD:
DOB:
FIGHTING WEIGHT:
PRO RECORD:
TRAINER:
TRAINER PHONE:
GYM NAME:
GYM PHONE:
Mail Application to: Black Gold Promotions, 1509 Vine Street, Hays, KS 67601
APPLICANT SIGNATURE:
DATE:
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