77th Virginia Closed
BLITZ Entry Form
(One form per player)

Print this form, fill it out, and mail the form and your payment to ARRIVE by Thursday, Aug 29th
Send to:  Mike Hoffpauir, ATTN: VA Closed, 405 Hounds Chase; Yorktown, VA 23693
Checks payable to "VCF"

Last Name: _____________________

First Name: ______________    MI: ______

 

USCF Member:     YES         NO               If Yes, write USCF ID Here:  __________________

Join or renew your US Chess Federation membership online at www.uschess.org, it's easier than joining or renewing at the tournament

Street Address:  _________________________

                          _________________________

Email:  ____________________

Phone:  ____________________

City:  ____________________,

State:  ________

Zip: ______________

Blitz Section you are entering (circle one):       OPEN (FIDE-Rated)            AMATEUR (under 1800 rating, USCF-Rated)

Entry Fee $25 by Mail before Aug 29th

 $35 if you wait to enter On Site

Your Total Payment:  _______