KANSAS CITY CHESS ASSOCIATION

Membership application

 

 

 

 

 

Name:

 

 

 

 

 

Address Line 1:

 

 

 

 

 

Address Line 2:

 

 

 

 

 

City, State, ZIP:

 

 

 

 

 

Telephone:

 

 

 

 

 

E-Mail Address:

 

 

 

 

 

 $5 Kids/$10Adults

 

Send form to:

Ken Fee 1537 Baker St. Liberty, MO 64068