Diana Tulman
  28 Canterbury Lane
  New Milford, NJ 07646





2018 Grandmaster-level Daily Summer Program
GRANDMASTER-LEVEL DAILY SUMMER PROGRAM Only seven weeks: 6/18-6/22 6/25-6/29 7/9-7/13 7/16-7/20 7/23-7/27 7/30 -8/3 8/20-8/24

ENTRY FORM
First Name:  Last Name:  Date of Birth: 
Home address: 
City:  State:  ZIP: 
Mother's Name:  Phone #: 
Father's Name:  Phone #: 
Home phone #:  E-mail:  USCF rating: 
Emergency Contact: 
Weeks' numbers: 1  2  3  4   5   6   7   8   9  Please check the week(s) number(s)
TOTAL ENCLOSED $________


Check should be made out to International Chess Academy
Mail the registration form and check to
Diana Tulman, 28 Canterbury Lane, New Milford, NJ 07646