Registration Form

The 2010 Connecticut State Scholastic & Open Championships
Tournament

Please Fill in the Form Below and Send by Mail, with check, to John M. Fikiet

Choose a Tournament

                   Scholastic

    K-8 Open______

    K-6 Open______    K-6 Reserve______   Must have rating over 700 to play in open.

    K-3 Open_______  K-3 Reserve______   Must have rating over 700 to play in open.

Name:  Last_____________________________________, First____________________________

Address:   Street________________________ City/Town___________________ State___ Zip_____

E-Mail Address_________________________________________

Name of School (If Scholastic)_______________________________________________

Date of Birth (If Scholastic)__________________________________________________

Byes: If you need a bye, please indicate which rounds (NO LAST ROUND BYES)

Fee:  $50 - if received 4 days before tournament;  $60 if received later or at site.

TOTAL PAID_____________

Connecticut State Chess Association (CSCA) Membership Required, $5 fee, but is included in entry fee.

United State Chess Federation Membership (USCF) REQUIRED.*     

USCF MEMBERSHIP #____________________ USCF RATING (If any)_____________________

If not a USCF member, you must join, see link below.*

*US Chess Federation (USCF) Membership REQUIRED to play in this Tournament.
Click here to JOIN USCF Online

Please Print and enclose a check payable to the University of Connecticut, Chess. Please send
to:
Mr. John Fikiet
University of Connecticut School of Engineering
U-Box 2037 261 Glenbrook Road
Storrs CT 06268