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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.