Illini 4000 2019 Bike America Team Application
You may want to type up your answers in a separate document to avoid losing your work. Please Contact with any questions.
Name *
Your answer
Primary Email Address *
Must be an or address
Your answer
Primary Phone Number *
Please use this format: (xxx) xxx-xxxx
Your answer
What is your current address? *
Street Address, Town, State, and Zip
Your answer
What is your hometown? *
City and State if you're from the US, City and Country otherwise
Your answer
Year in School *
What college do you attend? *
LAS, Engineering, Business, etc. if you are a student of UIUC; university name otherwise
Your answer
Birthdate *
Your answer
Gender *
Which languages do you speak? *
For the purpose of assisting ride leaders in communicating with emergency contacts
Your answer
From whom or where did you first hear about the Illini 4000? *
Your answer
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