Please make checks (no P.O.'s!) payable to and mail advance registrations to:
Mike Nietman, 201 Liberty Street, #3, Mauston, WI 53948
Please Print!!!
School Name:
Coach:
School Phone: ( ) Home Phone: ( )
E-mail:
Please check only if desired: My varsity team desires to play in Division I ____
My varsity team desires to play in Division II ____
Varsity USCF ID # Rating
1st Board ‘A’ Team:
2nd Board ‘A’ Team:
3rd Board ‘A’ Team:
4th Board ‘A’ Team:
5th Board ‘A’ Team:
1st Board ‘B’ Team:
2nd Board ‘B’ Team:
3rd Board ‘B’ Team:
4th Board ‘B’ Team:
5th Board ‘B’ Team:
NOTE: If the player has no USCF ID or rating, enter a zero in both columns. USCF ID’s and ratings may be confirmed at www.uschess.org/MSA. February rating supplement used.
Junior Varsity / K-8 / K-5 players: Section: Circle One
Name: J.V. / K-8 / K-5
Name: J.V. / K-8 / K-5
Name: J.V. / K-8 / K-5
Name: J.V. / K-8 / K-5
Name: J.V. / K-8 / K-5
Name: J.V. / K-8 / K-5
Name: J.V. / K-8 / K-5
Name: J.V. / K-8 / K-5
Name: J.V. / K-8 / K-5
Name: J.V. / K-8 / K-5
Name: J.V. / K-8 / K-5
Name: J.V. / K-8 / K-5
Name: J.V. / K-8 / K-5