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Winter Open
& Scholastic  
USPS Entry Form

Please Fill Out Form and mail to arrive by 1/12/16 - Checks ONLY to Chess For Life, LLC 
NAME






Checks ONLY to:

 Chess For Life, LLC
 
(please no checks to USCF or Tim)

Mail to:

Tim Just
37165 Willow
Gurnee, IL 60031

No phone or e-mail entries available





Total Enclosed
USCF ID



Street




City, State, Zip





e-mail/phone/contact




Section(s) (Please Circle)



Open ($69)                Open Playing Up ($79) - 


Reserve ($69) 


Scholastic Under 1200 ($25)        Scholastic Under 700 ($25)



Please circle round that you want your bye.


 Winter Open/Reserve:  1 - 2 - 3 - 4 -5  - None



Scholastic:  1 - 2 - 3 - 4 - 5 - None