East Bay Chess Club

	   1940 Virginia Street

	   Berkeley, CA 94704

	   www.eastbaychess.com
East Bay Chess Club Tournament Entry Form
 
Name: _____________________________________________ Age: _____________

Address: _____________________________________________________________

City, State, Zip: ____________________________________________________

Phone Number: ________________________________________________________

Email address: _______________________________________________________

USCF ID Number: ______________________________________________________

USCF Rating: _________________________________________________________

USCF Expiration: _____________________________________________________


Tournament Name: _____________________________________________________

Tournament Date(s): __________________________________________________


Entry Fee Enclosed: __________________________________________________
	When mailing in entries, please do not send cash.
	Make checks payable to “East Bay Chess”


Byes Requested: ______________________________________________________



Sign __________________________________________  Date ________________


	Please send this form, with the appropriate check amount, to
			East Bay Chess Club
			1940 Virginia Street, Box C
			Berkeley, CA 94709

	Or, you can come into the club and submit your form in person.