| Recruiter |
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| Team |
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| Gender |
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| Gamer Name |
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(without clan tags) |
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| First Name |
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Roster discloses only your first name.
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| Middle Initial |
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(optional) |
| Last Name |
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| Date of Birth |
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| List Age on Roster |
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| City / Town |
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| State / Province |
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| ZIP / Postal Code |
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(optional) |
| Country |
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| Internet Connection |
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| Favorite Map Type |
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| Favorite Quote |
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(optional) |
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| E-mail Contact Information |
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| E-mail Address |
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| Alternate E-mail |
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(optional) |
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| Instant Messenger Contact Information |
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| AOL Instant Messenger (AIM / AOL) |
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(optional) |
| Battle.net |
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(optional) |
| Google Talk / Gmail |
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(optional) |
| ICQ Instant Messenger |
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(optional) |
| Origin ID |
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(optional) |
| Steam ID |
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(optional) |
| Skype |
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(optional) |
| Windows Live Messenger (WLM) |
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(optional) |
| Xfire |
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(optional) |
| Yahoo Messenger (YM, YIM) |
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(optional) |
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| Games You Play |
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Referred by
How did you first hear about us? |
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Qualifications
Why should you be accepted?
How can you help & benefit us? |
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Comments, Questions, and Suggestions...
(optional) |
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| Do you own a working microphone? |
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| TeamSpeak Experience/Knowledge |
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| Mumble/Murmur Experience/Knowledge |
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| Ventrilo Experience/Knowledge |
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| IRC Experience/Knowledge |
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| Anti-Fraud Data Logging |
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| Your IP Address |
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| Your Host Name |
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| Your User-Agent |
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| HTTP Referrer |
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| Request URI |
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| Application Time Stamp |
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