Scribd
Upload
5K views1 page

Gujarat State Chess Association: Registration Form Photo

This document contains a registration form for the Gujarat State Chess Association. It requests information such as name, date of birth, address, contact details, FIDE rating, titles, and a declaration agreeing to abide by the rules of the association. Applicants are asked to provide biographical data and details of any prior disciplinary actions.

Uploaded by

allahabad
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
5K views1 page

Gujarat State Chess Association: Registration Form Photo

This document contains a registration form for the Gujarat State Chess Association. It requests information such as name, date of birth, address, contact details, FIDE rating, titles, and a declaration agreeing to abide by the rules of the association. Applicants are asked to provide biographical data and details of any prior disciplinary actions.

Uploaded by

allahabad
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

Gujarat State Chess Association

(Affiliated to All India Chess Federation) (Reg. No.Guj.280/F-0363)


Rifle Club, Nr. Bhavan's College, Khanpur, Ahmedabad 380001
Phone : (079) 22113746 • E-mail : bhavesh.chess@gmail.com
Website : www.gsca.in

REGISTRATION FORM
(To be filled in Block Letters)
PHOTO
1) Name Mr./Ms. ______________________________
2) Date of Birth ______________________________
3) Father/Husband Name ______________________________
4) Address __________________________________________
__________________________________________
__________________________________________
5) Tel. with STD code __________________________________________
6) Mobile Number __________________________________________
7) E-mail ID __________________________________________
8) Languages Known __________________________________________
9) Name of the District __________________________________________
to which the
apprentice belongs
10) FIDE Rating _______________ FIDE ID: ___________________
11) Titles if any __________________________________________
12) I have enclosed my bio-data: Yes No
13) Was any disciplinary action taken against you? If yes, furnish details:
_____________________________________________________________
_____________________________________________________________

DECLARATION

1) I, _________________________________________age _______________
S/o / D/o _____________________________ declare that the particulars
given above are true to the best of my knowledge and belief.
2) I also declare that I shall abide by the rules and regulations and the latest
amendments and decisions of the District / State Association / Federation
as the case may be and cooperate with the officials in participating in State
and National Tournaments / Championships. I also declare that I will not
officiate in any un-authorized tournament / championship.

Place:
Date: Signature of Apprentice

You might also like