reg..pdf | |
File Size: | 19 kb |
File Type: |
AJMER DISTRICT CHESS ASSOCIATION
(Affiliated To All Rajputana Chess Association & Sports Council)
[email protected]
PLAYER REGISTRATION FORM FOR THE YEAR – 200 – 200
( To be filled in Block Letters )
1. Name Mr. / Ms. : ________________________________________________________________________________
2. Son / Daughter of : _______________________________________________________________________________
3. Address for communication : ______________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
4. Telephone with STD Code : ___________________ Cell No: ____________________________________________________
5. Fax with STD Code : ___________________ Email ID: ___________________________________________________
6 Date of Birth with proof : ___________________ Mother Tongue: _____________________________________________
7 Name of the School/College/Office or Place : _____________________________________________________________________
8 FIDE Rating : _______FIDE ID No: ________________________________________________________________
9 Titles if any : _________________________________________________________________________________
10 Was any disciplinary action taken against you? If yes, furnish details: _______________________________________________
Declaration
1. I, ________________________________ age ____________ S/o / D/o. ________________________ declare that the particulars given above are true to the best of my knowledge and belief.
2. I also declare that I shall abide by the rules and regulations and the latest amendments and decisions of the State / District Chess Association / Federation as the case may be and cooperate with the officials in participating in State and National Tournaments / Championships.
3. I also declare that I will not participate in any un-authorized tournament / championship
4. I opt for _____________________ District/State Chess Association for participating in all chess activities.
Place:
Date : Signature
Note: Application to be submitted along with a fee of Rs.100/- . Two Photograph & Copy Of Date of birth certificate. All Payments should be paid by Cash.
For Office Use Only-
Application Fee Rs. 100/- received by cash /Cheque/D.D.No.-----------------
www.ajmerdistrictchessassociation.com
(Affiliated To All Rajputana Chess Association & Sports Council)
[email protected]
PLAYER REGISTRATION FORM FOR THE YEAR – 200 – 200
( To be filled in Block Letters )
1. Name Mr. / Ms. : ________________________________________________________________________________
2. Son / Daughter of : _______________________________________________________________________________
3. Address for communication : ______________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
4. Telephone with STD Code : ___________________ Cell No: ____________________________________________________
5. Fax with STD Code : ___________________ Email ID: ___________________________________________________
6 Date of Birth with proof : ___________________ Mother Tongue: _____________________________________________
7 Name of the School/College/Office or Place : _____________________________________________________________________
8 FIDE Rating : _______FIDE ID No: ________________________________________________________________
9 Titles if any : _________________________________________________________________________________
10 Was any disciplinary action taken against you? If yes, furnish details: _______________________________________________
Declaration
1. I, ________________________________ age ____________ S/o / D/o. ________________________ declare that the particulars given above are true to the best of my knowledge and belief.
2. I also declare that I shall abide by the rules and regulations and the latest amendments and decisions of the State / District Chess Association / Federation as the case may be and cooperate with the officials in participating in State and National Tournaments / Championships.
3. I also declare that I will not participate in any un-authorized tournament / championship
4. I opt for _____________________ District/State Chess Association for participating in all chess activities.
Place:
Date : Signature
Note: Application to be submitted along with a fee of Rs.100/- . Two Photograph & Copy Of Date of birth certificate. All Payments should be paid by Cash.
For Office Use Only-
Application Fee Rs. 100/- received by cash /Cheque/D.D.No.-----------------
www.ajmerdistrictchessassociation.com