MISSOURI CHESS ASSOCIATION


Membership application

 

 

 

 

 

Name:

 

 

 

 


Address Line 1:

 

 

 

 


Address Line 2:

 

 

 

 


City, State, ZIP:

 

 

 

 


Telephone:

 

 

 

 


E-Mail Address:

 

 

 

 


(required to access MCA Bulletin on the Web)

  

  

Annual Membership fees:

(circle one)

 

 

Printed MCB

MCB on the Web

 

Adult member

$ 12.00

$ 5.00

 

Scholastic member

$ 8.00

$ 5.00

 

Affiliate

$ 12.00

$ 5.00

 

 

 

 

Amount enclosed:

 

Today's date:

 

 


 


Comments:

 

 

 

 


 


 


Send form to:

Membership Chair, P.O. Box 417   Oak Grove, MO 64075