78th Virginia Closed
Main Event Entry Form
(One form per player please)

Print this form, Fill it out, and put your entry and payment in the Mail by Tuesday Aug 26th
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:  __________________; if not, write "NEW"

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

Street Address:  _________________________

                          _________________________

Email:  ____________________

Phone:  ____________________

City:  ____________________,

VA

Zip: _________

Birth Date: _____________

Section you are entering (circle one):       OPEN            AMATEUR (for ratings under 1800)

Optional Bye Requests (choose your byes by circling up to 2 rounds):       Rd 1       Rd 2       Rd 3       Rd 4       Rd 5       Rd 6

Entry Fee $65 until Aug 28th;
$80 if you wait to enter on-site

VCF Membership:  $10-Adult; $5-Junior
(Junior is 18 and under)

Your Total Payment:  _______