New Yorker Open!
Mail or FAX
Entry Form (v3)
INSTRUCTIONS
You can print the entry
form below on your printer, fill out all items, and
mail it NO LATER THAN MAY 19th to us at:
Chess Center of New York
P.O. Box 4615, New Windsor, NY 12553.
BE SURE TO INCLUDE A CHECK OR MONEY ORDER, payable to
"Chess Center of New York."
OR
If you want to use a FAX machine, print the form below on your printer, fill out all items, and FAX it to us at 845-562-0991, NO LATER THAN MAY 24th.
OR
If you have a FAX modem, cut and paste it into your word processing program, fill out all items, and FAX it to us at 845-562-0991, NO LATER THAN MAY 24th.
OR
Cut and paste it into your email, fill it out, and email it to us at chesscentr@aol.com, NO LATER THAN MAY 24th.
REGISTRATION MUST INCLUDE FULL PAYMENT OF ALL ENTRY FEES AND USCF MEMBERSHIP DUES !!
We do not confirm FAX, mail or email entries individually. However, a list of entries received will be posted at our website by May 26th.
Which section are you entering?
Which schedule are you entering?
1. Four-Day Schedule: Rounds Fri. 7 pm; Sat. 11 am, 6 pm; Sun. 11 am, 6 pm; Mon. 10 am, 4:30 pm.
2. Three-Day Schedule: Rounds Sat. 11 am, 2:30 pm, 6 pm; Sun. 11 am, 6 pm; Mon. 10 am, 4:30 pm.
3. Two-Day Schedule: Rounds Sun. 10 am, 12 pm, 2 pm, 4 pm, 6 pm; Mon. 10 am, 4:30 pm.
Half-point bye(s) may be requested in advance if unable to play which rounds (limit of three
byes): Open Section must commit before Round 2; other sections must commit
before Round 4:
Last Name, First Name of Player:
Address of Player (Street number, city, state and ZIP):
USCF Membership is required. Please provide USCF information below:
USCF Status: (Current Member, Joining now, or Renewing Now):
(8-digit) USCF ID#:
USCF Expiration (mm/yy):
May 2011 Official USCF Rating (or latest official, published rating):
Those who are joining or renewing USCF now, please indicate membership type:
Membership Type
Premium Adult Membership: $49/year (includes 12 monthly issues of Chess Life
magazine), OR
Senior membership: age
65/above, $36/year (includes 12 monthly issues of Chess Life
magazine), OR
Premium
Young Adult membership: age
24/below, $32/year (includes 12 monthly issues of Chess Life
magazine), OR
Premium Youth membership:
age
15/below, $27/year (includes 6 bi-monthly issues of Chess Life
magazine), OR
Premium Scholastic membership: age
12/below, $23/year (for 6 bimonthly issues of Chess Life For
Kids)
Credit Card Information
Type of card (Visa, Mastercard, Discover, American Express):
Card Number:
Expiration Date (mm/dd/yy):
Card Verification Number (The
3-digit "CVN" is usually on the back, following the
main card number;
(except the American Express CVN is usually 4 digits, and is
usually on the front of the card):
Name of Cardholder:
Billing Address of Cardholder:
Daytime Phone:
Evening Phone:
Email Address:
THANK YOU FOR ENTERING THE NEW YORKER OPEN!