2011 Scholastic Club Entry Form

Please choose a tournament below and fill all required fields, which are labeled bold. You will receive an email once your form has been processed. If you have any questions, please contact Mike Smith . All entries before midnight 11/05/11are charged $15. All entries received after 11/04/11 will be charged $25. No entries after 11/11/10.

tmail.com
Tournament:  

Player Information

Club Information
Name (Last, First):       Coach Name:      
Street Address 1:       ClubName:      
Street Address 2:

Coach Email:

      
City:      

Player Email:
State:      
Zip Code:      
Birth Date (MM/DD/YYYY):  /   /       

Association Information

Fees
USCF ID #:       Entry Fee: $25
USCF Rating:       USCF Fees: $0
USCF Expiration (MM/YY):  /        MCA Fees: $0
USCF Fee:      Total: $25
MCA Expiration (MM/YY):  /       
MCA Fee: