Diana Tulman
  28 Canterbury Lane
  New Milford, NJ 07646





2012 MASTER-LEVEL TRAINING SUMMER PROGRAM
Head Trainer: Master Sergei Grabuzov Sergey is a graduate of the \"Russian State University of Physical Education,\" and dating back to 1990 has trained and prepared five current Grandmasters, and an infinite number of International Masters.

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