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 18th 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 23rd.

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 23rd.

OR

Cut and paste it into your email, fill it out, and  email it  to us at chesscentr@aol.com,  NO LATER THAN MAY 23rd.

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 24th.

Which section are you entering?

1. Open Section
   
   
2. Under 2300 Section
    
3. Under 2000 Section
    
4. Under 1600 Section
    
5. Under 1200 Section

    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):

Mixed Doubles Bonus Prizes are also awarded to the 3 top-scoring male/female teams in all sections,
but the average rating of the 2 players must be Under 2200!

If you are also interested in the optional Mixed Doubles Bonus Prizes, who is your Mixed Doubles Teammate:

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 2012 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: $46/year (includes 12 monthly issues of Chess Life magazine), OR
Senior membership: age 65/above, $37/year (includes 12 monthly issues of Chess Life magazine), OR
Premium Young Adult membership: age 24/below, $33/year (includes 12 monthly issues of Chess Life magazine), OR
Premium Youth membership: age 15/below, $25/year (includes 6 bi-monthly issues of Chess Life magazine), OR
Premium Scholastic membership: age 12/below, $24/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!

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