20th
The Telegraph Schools Chess Championship

        NAME    

        ADDRESS WITH PIN CODE

         PHONE NO                                    MOBILE NO (SELF/ FATHER/ MOTHER)

        FATHER'S NAME                                                  MOTHER'S NAME

        NAME OF SCHOOL AND ADDRESS WITH PHONE NO

        CLASS                      SECTION                              ROLL NO

        DATE OF BIRTH

        ELO RATING (IF ANY)                                         TITLE (IF ANY)

        ACHIEVEMENT IN CHESS (IF ANY)

        REGISTRATION NO - AICF (for all players)  
       
        WBCA (for West Bengal Players)

         Dated, Kolkata ................

        Signature of Father/ Mother                                          Signature of applicant

----------------for office use----------------

              R.No :                Date :                AICF &/OR WBCA Regn Fee :                                              Paid/Unpaid

............................................................................
signature of staff

Entries are subject to acceptance by the Committee of Alekhine Chess Club. 
Entry fee once paid will not be refunded except in case of rejection of any entry.

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