Enter the following information, and then submit this by email and print this page and mail it along with your entries to:PSCF, c/o Tom Martinak, 25 Freeport Street, Pittsburgh PA 15223-2245.
Your Name:
Your Address:
City: State: Zip Code:
Your e-Mail Address:
Your Phone #:
Your Birthday (needed for USCF, PSCF memberships, and eligibility for section entered):
Section to enter:
Your USCF ID #: Expiration Date: Rating:
Byes Needed in Rounds (Players may request ½-Byes in rounds for which they are not available to play. Limited to less than half of the total number of rounds.):
If representing a team, Team Name:
and Coach/Captain Name:
Entry Fee (2-day sections : by 11/14 $18; later $28. Sunday-only Sections : by 11/14 $15; later $25):
USCF Membership Fee (required if your USCF membership has expired, Young Adult $23, Youth $17, Scholastic $15):
PSCF Membership Fee (required if your PSCF membership has expired, $5):
Total Fees (Make checks payable to : PSCF):
