Ohio Scholastic Chess Association

Membership Application/Renewal

Please type or print CLEARLY all information and submit to OSCA Membership Secretary David Bills via email wc3@chess.com, fax 216-721-6805, or mail David Bills, 1322 Carol Dr, Kent, OH  44240.  No payment is required.

School Name:

School Address:

City, State and Zip Code:

School Telephone:                                                                    School Email:

County in which building is located:                                           School Web Site

USCF Affiliate ID, if any:

This school is a:

__ Public or Private School

__ Virtual School

__ Home School Organization: please attach a complete description explaining how you meet the criteria outlined in OSCA Bylaws Section 2.3.1c to be recognized as a school

__ Home School Family: please attach letter excusing student(s) from public school attendance

Representative Name:

Address:

City, State, Zip:

Email (required):                                                                       Telephone:

Connection with school chess program:

Name:

Connection with school chess program:

Date Completed:

Rev 9-4-09