Tournament Entry Form
  

Please make checks payable to "Alaska Chess League" and send to:
Alaska Chess League, c/o George Lombardi,
PO Box 868
Kenai AK 99611-0868

KENAI CHESS CHALLENGE 2004

NAME:________________________________________________

EMAIL:________________________________________________

ADDRESS:_____________________________________________

CITY:_________________________________________________

STATE AND ZIP:________________________________________

BIRTHDATE:___________________________________________

SCHOOL GRADE:________________________________________

USCF #ID:_____________________________________________

RATING:______________________________________________

DISCOUNTS:___________________________________________

ENTRY FEE:____________________________________________

USCF MEMBERSHIP DUES:_________________________________

TOTAL:________________________________________________

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