Registration form for the simultaneous
exhibition being given by FM James Schuyler
Name
_______________________________________________________________________
Last, First, MI
City: ___________________________________________________________
State: ________
Age: ________________ Gender:
_________ Color Preference (W or B):
____________________
If you are a USCF member, please provide the following
ID #: ____________________________________ Rating:
___________________
Amount Enclosed ($15 if received by 2/16)
___________________
Make checks payable to: Virginia Chess
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