Enrolment Form

Thank you for your interest in joining NCG. Currently, all membership dues and enrollment fees are waived for your first 2 years. Once your membership has been approved, we will ask you to place the NCG logo on your index page of your website. If you are a LAN center or gaming outlet, we will send you a png art file for print free of charge or provide you with NCG membership sign for $39. Thank you for your interest in joining National Championship Gaming. Together, we will win.

	First Name	:
	Last Name	:
	Address line 1	:
	City	:
	State	:
	ZIP Code	:
	Email Address	:
	Phone	:
	Business Name	:
	Business Type	:

	Website URL	:
	How many members do you have? (20 minimum)	:
	Logo (png, jpg, gif formats only. Maximum size [1MB])	:

	How many Xbox 360's do you have?	:
	How many PS3s do you have?	:
	How many PCs do you have?	: