ALL INDIA CHESS FEDERATION (Reg : 125 / 1958)

ARBITER REGISTRATION FORM FOR THE YEAR – 20 – 20

For Indian Citizens Only

( To be filled in Block Letters )

1. Name Mr. / Ms. : ______DOB : ______

2. Father / Husband Name : ______

3. Address for communication : ______

______

______

4. Telephone with STD Code : ______Cell No : ______

5. Email ID : ______Languages known: ______

7 Name of the State / Affiliated Unit to which the

Arbiter belongs : ______

8 FIDE Rating : ______FIDE ID No : ______OLD AICF Reg.No.______

9 Titles if any : ___IA / FA / Sr NA ______

10. I have enclosed my biodata : Yes / NO

11 Was any disciplinary action taken against you ? If yes, furnish details : ______

Declaration

1.  I, ______age ______S/o / D/o. ______declare that the particulars given above are true to the best of my knowledge and belief.

2.  I also declare that I shall abide by the rules and regulations and the latest amendments and decisions of the District / State Chess Association / Federation as the case may be and cooperate with the officials in participating in State and National Tournaments / Championships. I also declare that I will not officiate in any un-authorized tournament / championship

Place :

Date : Arbiters’ Signature

Recommendation from State Chess Association

Mr. / Ms.______belongs to our state and his / her knowledge and performance as Arbiter is Please tick the appropriate

Excellent Very Good Good Moderate

Signature of the State Secretary with seal

Note : Application to be submitted along with a fee of Rs.1000/- . All Payments should be paid by Demand Draft favouring All India Chess Federation payable at Chennai. For Migration from one Affiliated Unit / State Association to another, the No Objection Certificate of the former Affiliated Unit is to be obtained before getting registered with the new Association.