Before filling out this form for

Before filling out this form for any contest please read the online entry form carefully because not all the competitions feature all of the same events. Check off only the events that are offered at the contest you are entering. Thank you.

E-mail Address: *
First Name *
Last Name *
Mailing Address *
City *
State *
Zip Code *
Phone Number
Age *
Location of Contest you are entering *
Date of Contest you are entering *
Name of Contest you are entering *
What gear category will you be lifting in *	I am lifting RAW I am lifting in Standard Gear I am lifting in Unlimited Gear
Which contest will you be entering in. Please read entry form carefully because not all competitions feature the same events *	Full Power Push and Pull Bench Press Only Deadlift Only Strength Sports Overhead Press Strict Curl
Drug Tested or Non-Tested category *	Drug Tested Non Tested
Weight Class *	97 105 114 123 132 148 165 181 198 220 242 275 308 341 Superheavyweight
Divisions you are entering *	Powerlifting - Open Division Powerlifting - Youth Division ages 8 to 12 Powerlifting - Teenage Division Powerlifting - Submaster Division ages 33 to 39 Powerlifting - Master 40 to 49 yrs Powerlifting - Master 50 to 59 yrs Powerlifting - Master 60 to 69 yrs Powerlifting - Master 70 to 79 yrs Powerlifting - Master 80 and above Powerlifting - Police and Firefighters Div Powerlifting - Military Division Push and Pull - Open Division Push and Pull - Youth ages 8 to 12 Push and Pull - Teenage Division Push and Pull - Submaster ages 33 to 39 Push and Pull - Master 40 to 49 yrs Push and Pull - Master 50 to 59 yrs Push and Pull - Master 60 to 69 yrs Push and Pull - Master 70 to 79 yrs Push and Pull - Master 80 and above Push and Pull - Police and Firefighters Div Push and Pull - Military Div Bench Press Only - Open Division Bench Press Only - Youth ages 8 to 12 Bench Press Only - Teenage Div Bench Press Only - Submaster ages 33 to 39 Bench Press Only - Master 40 to 49 yrs Bench Press Only - Master 50 to 59 yrs Bench Press Only - Master 60 to 69 yrs Bench Press Only - Master 70 to 79 yrs Bench Press Only - Master 80 and above Bench Press Only - Police and Firefighters Div Bench Press Only - Military Div Deadlift Only - Open Division Deadlift Only - Youth ages 8 to 12 Deadlift Only - Teenage Div Deadlift Only - Submaster ages 33 to 39 Deadlift Only - Master 40 to 49 yrs Deadlift Only - Master 50 to 59 yrs Deadlift Only - Master 60 to 69 yrs Deadlift Only - Master 70 to 79 yrs Deadlift Only - Master 80 and above Deadlift Only - Police and Firefighters Div Deadlift Only - Military Div Strength Sports - Open Div Strength Sports - Youth 8 to 12 Strength Sports - Teenage Strength Sports - Submaster 33 to 39 Strength Sports - Master 40 to 49 Strength Sports - Master 50 to 59 Strength Sports - Master 60 to 69 Strength Sports - Master 70 to 79 Strength Sports - Master 80 and above Strength Sports - Police and Firefighters Div Strength Sports - Military Div Overhead Press - Open Div Overhead Press - Youth 8 to 12 Overhead Press - Teenage Overhead Press - Submaster 33 to 39 Overhead Press - Master 40 to 49 Overhead Press - Master 50 to 59 Overhead Press - Master 60 to 69 Overhead Press - Master 70 to 79 Overhead Press - Master 80 and above Overhead Press - Police and Firefighters Div Overhead Press - Military Div Strict Curl - Open Div Strict Curl - Youth 8 to 12 Strict Curl - Teenage Strict Curl - Submaster 33 to 39 Strict Curl - Master 40 to 49 Strict Curl - Master 50 to 59 Strict Curl - Master 60 to 69 Strict Curl - Master 70 to 79 Strict Curl - Master 80 and above Strict Curl - Police and Firefighters Div Strict Curl - Military Division Powerlifting - Novice Division - For those who have never won 1st place in a competition sanctioned by any organization Push and Pull - Novice Division - For those who have never won 1st place in a competition sanctioned by any organization Bench Press - Novice Division - For those who have never won 1st place in a competition sanctioned by any organization Deadlift - Novice Division - For those who have never won 1st place in a competition sanctioned by any organization Strength Sports - Novice Division - For those who have never won 1st place in a competition sanctioned by any organization Overhead Press - Novice Division - For those who have never won 1st place in a competition sanctioned by any organization Strict Curl - Novice Division - For those who have never won 1st place in a competition sanctioned by any organization
Are you presently under suspension with any powerlifting organization *	Yes No
Records you hold with various organizations
Are you a certified referee with any powerlifting organization *	IPF Referee USAPL Referee USPF Referee AAU Referee NASA Referee APA or WPA affiliate Referee APF Referee I am not a certified referee or am not a referee with any of the traditional and long established federations
Have you ever won a 1st place award in a competition? *	Yes No
Years lifting	Less than one year One to 3 years Over 3 years
Anticipated contest bodyweight
Do you have any documented physical disability that will prevent you from perfoming the lifts correctly? If so you must bring a signed note from a physician to the contest as proof *	No documented disability or limitation Yes I have a documented disability that would impair performance of some lifts and will bring signed medical documentation to the event
By virtue of the acceptance of this entry, my typed signature here indicates that I agree to abide by the rules of the APA and honor the terms outlined on the APA membership application. I will receive no refund if I am disqualified from a competition or do not show up to the event. *

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