www.phillyasap.org

Date:___________________________

Player Name:____________________________

Address:_________________________

___________________________

Birthdate:_______________________

School/Chess Club Name:_____________________

Coach:_____________________Grade:________

Phone no:_______________________

E-mail address:__________________________

*USCF ID:__________Exp:____Rtg:_____

Grand Prix (Nov. 20th Only):_______(Yes/No)

Section: Non-rated (K-5, K-8, K-12)________

Section: USCF Rated (K-5, K-8, K-12)__________

Scholastic Open:__________

Return this form to ASAP no later then the Wednesday 5pm before the tournament to bcooper@phillyasap.org or fax: 215-545-3054 or ATTN: Ben Cooper 1520 Locust St. Suite 1104 Philadelphia, PA 19102

*Players wishing to compete in USCF rated sections must provide USCF ID numbers and expiration dates.