Please enter the information requested.
SCHOOL
SCHOOL ADDRESS POSTCODE
POSTAL ADDRESS (if different) POSTCODE
SCHOOL PHONE SCHOOL FAX
LOCATION OF CHESS ROOM
CHESS COORDINATOR (Mr/Mrs/Miss/Ms/Dr)
(Please indicate whether principal, teacher, parent, etc.)
EMAIL ADDRESS
AFTER HOURS PHONE MOBILE
An after hours and/or mobile phone number is requested for the NSWJCL Coordinator and Regional Convenor's use,
but if you would prefer not to have these listed in the Competition booklet please indicate by NFP (not for publication.)
GRADE Number of teams
JUNIOR (Years 7 and 8 only)
INTERMEDIATE (Years 9 and 10 only)
SENIOR (Years 11 and 12 only)
ENTRY FEES teams @ $33 (including GST) = $
Please forward payment later, when you receive a tax invoice
COMMENTS:
ENTRIES CLOSE Friday 9 March 2012. The Competition will start on Friday 4 May.
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).
