Fighters Information

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* 1. Fighters Information

Coach Information

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* 2. Coach Information

Local Boxing Club Name/Affiliation

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* 3. Local Boxing Club Name/Affiliation

Weight Class

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* 5. Weight Class

Total number of Amateur Bouts

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* 6. Total number of Amateur Bouts

Age of fighter

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* 7. Age of fighter

Fighters Date of Birth

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* 8. Fighters Date of Birth

Sex

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* 9. Sex

 Mail Entry Fee to P.O. Box 882 O'Fallon, IL 62269

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* 10.  Mail Entry Fee to P.O. Box 882 O'Fallon, IL 62269

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