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      PERSONAL INFORMATION
First name *                                         Last name *
                             

Home Address
             
City               State         Zipcode    

E-Mail Address *
             

Name of Your School
             

Address of High School
             
City               State         Zipcode    


      YOUR VHOOPS.COM INFO
Video Format (How you would like your video?) VHS Video CD.

Mailing Address (Which address would you like video mailed to?) Home School

What players are you most interested in?

Interested Players (If players are interested in your school, can we...?)
Email you notifications of their interest
Send you video of the interested players
Do both of the above
Do neither of the above


      LOGGING INFORMATION
Choose a Username and Password
This will be your user ID and password to login to the VirtualHoops.
Use a dash (-) or underscore ( _ ) to separate words. Please do not space.

Username *

Password *


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