Contact Information Update Form

Contact Update Form

Thank You for taking the time to update your contact information with the club. This is an important step in keeping our team registered and compliant. It also ensures we can contact you whenever necessary.

Please Note: You will need both your UWM Student ID Number, USA Rugby CIPP Number and Emergency Contact Information to complete this form.

None of the information you provide will be shared with anyone other than the UW-Milwaukee Women's Officers, the UW-Milwaukee Registrar and USA Rugby. None of the information you provide will ever be made accessible to the public at any time.

* Denotes Required Field

Personal Information

First Name:*

Middle Name:

Last Name:*

Maiden Name:

Birthdate:*

Gender:*

Current Contact Information (Your campus/current address)

Street Address:*

Apartment or Unit :

City:*

State:*

Zip Code:*

Cell Phone:*

Cell Phone Company:*

E-mail Address:*

Emergency Contact Information (if you are injured)

Contact's Full Name:*

Relationship:*

Contact's Address 1:*

Contact's Address 2:

Contact's City:*

Contact's State:*

Contact's Zip Code:*

Contact's Phone:*

Contact's Phone Type:*

Contact's Email:

Registration and Eligibility Information

To complete this section you will need your UWM Student ID Number and your USA Rugby CIPP Number (you can click on the links to obtain these numbers).

Note: If you haven't registered with USA Rugby for a while, you may be unable to find your CIPP Number. If you are unable to obtain your CIPP Number, please write "not found" in the field so we can contact USA Rugby and obtain your number.

If you are a new player to the club, please make sure to enter your Previous Club so we can transfer your USA Rugby CIPP registration to UW-Milwaukee.

UWM Student ID Number:*

USARugby CIPP Number:*

Previous Club:* (or none)

Military Status:*

Year in College:*

Enrollment Status:*

Date Enrolled in College:*

Years Played at UWM:*

Years Played (total):*

Thank you for taking the time to update your contact information. This will help us keep our club sompliant for all Wisconsin, Midwest and USA Rugby events.