Candidate

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Tamil Nadu State Chess Association Mandatory
Application
Examination for Chess Coaches - Level 1 (Beginners)

1. Name of the candidate: ____________________________________________________________

(in Block letters)
2. Son /Daughter of : ____________________________________________________________
3. Age & Date of Birth : _____ ______________ (18 years of age as on 1st december, 2021)

4. Gender: Male / Female: ________________

5. Address : _______________________________________________________________

________________________________________________________________

________________________________________________________________
(Mandatory: copy of the residential address proof to be enclosed: such as Aadhaar card / passport /
Voter ID / Driving license, etc.)

6. District: ________________________________
7. Email ID: ______________________________________________________________
8. Mobile number: ______________________________ Landline: ______________________
9. FIDE iD: ______________________ Rating if any: ______________________
10. Was any disciplinary action taken against you? If yes, furnish details: _________________________

DECLARATION

1. I declare that the particulars given above are true to the best of my knowledge and belief.
2. I declare that I shall abide by the rules and regulations and the latest amendments of TNSCA.

Place:

Date: Signature of the candidate

Recommended and forwarded to Tamil Nadu State Chess Association

Name of the District Association: Signature of District Secretary

Seal