Please enter the information requested.
SCHOOL
SCHOOL ADDRESS POSTCODE
POSTAL ADDRESS (if different) POSTCODE
SCHOOL PHONE SCHOOL FAX
CHESS COORDINATOR (Mr/Mrs/Miss/Ms/Dr)
(Please indicate whether principal, teacher, parent, etc.)
EMAIL ADDRESS
REGION (Indicate by X)
NORTH COAST ENTRY FEE $22 (including GST)
SOUTH COAST Please forward payment later,
HUNTER when you receive a tax invoice.
WESTERN Payment may be sent by post or
NORTH WEST by direct deposit (details will be
RIVERINA provided on the invoice).
COMMENTS:
ENTRIES CLOSE Friday 19 February 2010. The first round will be played before the end of first term.
After submitting your entry you will be shown the details as confirmation of what you have sent
(you may print this if desired). You may then exit (or return to the form).
