Name__________________________________USCF ID_______________ Exp. Date______________
   (As shown on ID Card if USCF member)     ("NEW" if first time m'ship)

Address___________________________________________________Section___________________

Scholastics: Enter School Name and Grade____________________________________________

Total Enclosed (circle all included) $_______; Entry Fee; USCF M'ship; ACF M'Ship;
Make single check payable to Huntsville Chess Club.

Specify USCF Membership as New_______ or Renewal_______ (Check one).

Submit one form for each entrant.

Please include PLAYER name(s) on check.

ACF Memberships available on-site.

Send proof of USCF membership: copy of card, magazine mailing label or printout of 
on-line receipt. On-site entrants bring proof of USCF and ACF membership. USCF 
memberships available via www.uschess.org.  We encourage everyone to use the on-line 
USCF membership application.