Registration Form Certificate for Chess Coaches
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Transcript of Registration Form Certificate for Chess Coaches
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Tamil Nadu State Chess Association(Regd.No. 48/1960)
Room No. !" #a$aha%lal Neh%u Stadium" &e%iamet" Chennai '600 00.
Certificate for Chess Coaches -Level 1 (Beginners)
Chennai 21stFebruary, 2016
Name of the Participant:-----------------------------------------------------------------------------------------
(in Block letters)*Date of Birth: --------------------- Age (above 18ears) ------- !en"er
#ale$%emale
*&"'cational 'alication
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on$Da'ghter of:
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A""ress: ---------------------------------------------------------------------------------
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District --------------------------------------------------------------------
tate +amil Na"'
&-mail:
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#obile: ---------------------------------------- ,an"line:
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%D& " (if an) ---------------------------------------- .ating:
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+N/A .egistration (if an): ---------------------------------------- #other +ong'e:
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aAn "isciplinar action taken against o'0 f es f'rnish "etails:
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* /op of certicate as proof to be appen"e"3
*C+ARAT,-N
13 22222222222222222222222222222222 age 222222222222 $o $ D$o
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"eclare that the partic'lars given above are tr'e to the best of m kno4le"ge an"
belief353 also "eclare that shall abi"e b the r'les an" reg'lations an" the latest
amen"ments an" "ecisions of the tate $ District /hess Association $ %e"eration as
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the case ma be an" cooperate 4ith the o6cials in participating in tate an"
National +o'rnaments $ /hampionships3
73 also "eclare that 4ill not participate in an 'n-a'thorie" to'rnament $
championship an" also e"'cate st'"ents 'n"er m coaching abo't the above3
93 opt for 222222222222222222222 District /hess Association for participating in all
chess activities3
Place:
Date: ignat're
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.ecommen"e" an" for4ar"e" to +amil Na"' tate /hess Association
Name of the District Association: ignat're of
ecretar
eal
