Copyright 1999 - 2004.  All Rights Reserved.

Internet Chess Coordinator:  Patricia Knight

Tennessee Chess Association

Team Registration Form

                           ***PLEASE PRINT OR TYPE - COMPLETE ALL ITEMS ON FORM***

            School Name_____________________________________School Nickname_____________________

               

     School Address_______________________________________________________________________                                                  

     School Telephone_______________________________Section Entered_______________________

               

     School E-Mail_________________________________________Entry Fee______________________            

         

Email Us

1.  Board 1:

Name:_________________________________

Address:_______________________________

Phone:_________________________________

Email:__________________________________

Date of Birth:____________________________

Grade:_________________________________

USCF ID. No.___________________________

Rating:_________________________________

                 Team Coach or Sponsor_________________________________________________________________                                           

                 Address______________________________________________________________________________                                                       

                 Telephone_______________________________ E-Mail _______________________________________                      

                 Mail To & Make Checks Payable to Your Regional Coordinator:

2..  Board 2:

Name:_________________________________

Address:_______________________________

Phone:_________________________________

Email:__________________________________

Date of Birth:____________________________

Grade:_________________________________

USCF ID. No.___________________________

Rating:_________________________________

3.  Board 3:

Name:_________________________________

Address:_______________________________

Phone:_________________________________

Email:__________________________________

Date of Birth:____________________________

Grade:_________________________________

USCF ID. No.___________________________

Rating:_________________________________

4.  Board 4:

Name:_________________________________

Address:_______________________________

Phone:_________________________________

Email:__________________________________

Date of Birth:____________________________

Grade:_________________________________

USCF ID. No.___________________________

Rating:_________________________________

5.. Alternate 1:

Name:_________________________________

Address:_______________________________

Phone:_________________________________

Email:__________________________________

Date of Birth:____________________________

Grade:_________________________________

USCF ID. No.___________________________

Rating:_________________________________

6.. Alternate 2:

Name:_________________________________

Address:_______________________________

Phone:_________________________________

Email:__________________________________

Date of Birth:____________________________

Grade:_________________________________

USCF ID. No.___________________________

Rating:_________________________________

REGION 1

Pat Knight

103 Albion Road

Oak Ridge,  TN  37830

(865) 481-3516

REGION 2

Harry D. Sabine

P.O. Box 381

Crossville,  TN  38557

W:  (931) 484-9593

Fax:  (865) 456-7624

REGION 3

Chris Prosser

733 Long Hunter Court

Nashville,  TN  37217

(615) 399-8432

REGION 4

Bill Cummings

3532 Davieshire Dr.

Memphis,  TN  38133

(901) 372-6584

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