Name:
Team/Gym/Promotion Name
Team/Gym/Promotion Website or MySpace Address
Email Address:
Shipping Address & Phone Number
American Stand Up Affiliation (Check all that apply) Fighter
Fight Team Manager
MMA Gym Manager
Event Promoter
Graphic Artist
Writer
Other
Fight Team Size (Fighters) 5+
10+
20+
50+
N/A
Gym Size (Total Students) 10+
20+
50+
100+
200+
N/A
Promotion Size - Promoters Only (Average venue) 200+
500+
1,000+
2,500+
5,000+
N/A
How did you affiliate with American Stand Up?
Other Comments (Titles, Awards, Featured Fighters)
If selected to participate in the upcoming "American Stand Up" national television show would you provide full access to your team/facility/promotion Yes
No
If selected to participate in the upcoming "American Stand Up" national television show what potential story lines could you present

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