AMERICAN CHESS ASSOCIATION
JOIN THE ACA

FULL NAME______________________________________________________

STREET ADDRESS_________________________________________________

CITY __________________________________________________________

STATE__________________________________________________________

ZIPCODE________________________________________________________

EMAIL ADDRESS__________________________________________________

BIRTHDATE______________________________________________________

USCF RATING?___________________________________________________

Print this form, fill in the information and send cash, check, or money order in the amount of $1.00 to:

American Chess Association
Attn: Membership Director
3612 North Silver Sand Court
North Las Vegas NV 89032-7688