Greater New York Scholastics
Entry Form (v1)
Saturday - Sunday, January 26 - 27, 2013
If you are mailing this entry form,
print out the form below, fill out all items, and enclose a check
for payment of all entry fee(s) and any USCF membership dues (all
players must be USCF members thru at least 1/31/13)
payable (one check for the total amount is best) to:
THE CHESS CENTER OF NEW YORK, P.O. Box 4615, New Windsor, NY 12553
If you prefer to mail your credit card information to use for payment, you can provide your credit card information below.
MAIL ENTRIES MUST BE POSTMARKED NO LATER THAN JANUARY 4, 2013!
IF YOU MUST CONFIRM RECEIPT OF YOUR MAIL ENTRY, ENCLOSE A SELF-ADDRESSED, STAMPED POSTCARD: MAIL ENTRIES ARE NOT CONFIRMED BY PHONE!
Print the form below on your printer, fill out all items, and FAX it to us at 845-562-0991, NO LATER THAN JANUARY 11th.
We do not confirm FAX, mail or email entries individually. However a list of entries received should be posted at this website by January 24th.
Circle the tournament(s) and section(s) below for which you are paying the entry fee:
Name of Player (Last Name, First Name, Middle):
Player's Email Address:
Street Addess of Player:
City, State, Zip of Player:
Address (city, state) of School:
USCF Membership is required. Please provide USCF information below:
USCF Status: (Current Member, Joining now, or Renewing Now):
USCF Expiration (mm/yy):
January 2013 USCF Rating:
Those who are joining or renewing now,
please indicate membership type:
Premium Young Adult membership, age 24/below, $33 extra per player for 12 issues of Chess Life magazine, or
Online Young Adult membership, age 24/below, $26 extra per player for access to Chess Life Online, or
Premium Youth membership, age 15/below, $28 extra per player for 6 issues of Chess Life magazine, or
Online Youth membership, age 15/below, $22 extra per player for access to Chess Life Online, or
Premium Scholastic membership, age 12/below, $24 extra per player for 6 issues of Chess Life For Kids magazine, or
Online Scholastic membership, age 12/below, $17 extra per player for access to Chess Life For Kids Online.
USCF 3-Month Memberships: $10 extra per player, age 24/below, includes 3 issues of Chess Life magazine,
or $8 extra per player age 12/below, includes 2 issues of Chess Life For Kids.
Credit Card Information:
Type of card:
Expiration Date (mm/dd/yy):
Card Verification Number (CVN), 3-digit number (4-digits for AMEX), usually printed immediately after the Card Number:
Name of Cardholder:
Mailing Address of Cardholder:
Signature of above cardholder authorizing this credit card charge for payment of chess tournament registration(s) and any additional USCF Membership dues, as indicated
THANK YOU FOR ENTERING THE 47th ANNUAL GREATER NEW YORK SCHOLASTICS!