NORTHWEST CHESS

WASHINGTON CHESS FEDERATION (WCF) & OREGON CHESS FEDERATION (OCF)

SUBSCRIPTION / MEMBERSHIP APPLICATION / RENEWAL FORM

Adult: $25/year or $60 for 3 years. Adult members receive Northwest Chess via periodicals mail each

month. Residents of OR and WA also receive a membership in the OCF or WCF.

Junior: $17/year or $40 for 3 years. Junior members also receive Northwest Chess each month. Must be

under age 21 at time of expiration. OR/WA residents only; state membership included.

Subscriber: $25/year or $60 for 3 years. For clubs and organizations or for persons living outside the

OR/WA area. Subscribers receive Northwest Chess each month. Additional postage required for foreign

addresses other than Canada. Inquire about special rates for libraries and school chess clubs.

Scholastic: $10 for 6 months. Same as junior membership, except for 6 months only. Can be converted

to a regular junior membership by paying the balance before expiration.

Family: $5/year or $12 for 3 years (not a subscription — membership only). This class of membership

is open only to co-residents of an Adult or Junior member. Expires at the same time. If first member is a

junior, additional family member(s) must also be juniors.

Name ________________________________________________

If Junior(s), please give date(s) of birth ________________

E-Mail (strongly recommended; used for annual renewal notices and occasionally for tournament announcements)

__________________________________________________

Phone Number (optional, will not be used for telemarketing) ( ______ ) _________________

Street or P.O. Box _________________________________________________________

City __________________________________ State ______ Zip ___________________

Country (if not USA) _____________________ Please e-mail for additional postage amount.

Membership type(s) ______________________ Total Membership Amount $ ____________

Washington residents only: sales tax based on location where magazine will be received.

Tax jurisdiction: City ________________ or unincorporated county ________________

Sales tax rate: _________%, Tax on membership amount: $_________, Total: $__________

A tax rate table is available on the Northwest Chess website. Memberships received without the

correct tax will be valid for only 11 months per year instead of 12 (5 months for scholastic option).

Make check or money order for total amount (USA $ only) payable to Northwest Chess and mail to:

Eric Holcomb, NW Chess Business Manager

1900 NE 3RD ST STE 106-361

BEND, OR 97701-3889 USA

For general information: Eric Holcomb (541) 647-1021, e-mail: Eric@Holcomb.com

Grand Prix for Organizers/Promoters

Individuals or chess clubs/organizations involved in organizing chess events or promoting chess can

receive credit for new or renewing members that they helped sign up. Prizes for this “grand prix” will be

awarded each year. To receive credit, please use this form and complete this section. Thank you for

supporting Northwest Chess!!

Name of organizer/promoter: ____________________________________ Date: _________