AD Chess Club - Registration Form

Membership Form

Fill out the form carefully for registration
Registration Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Nationality
English Full Name As per Passport
Full Name
Name

First NameMiddle Name Family Name
Date of birth

MonthDayYear
Gender
Address

Street, Building

Street Address Line 2

CityArea

P.O. Box
School / University (if any)
NA if no School
Passport Number
Passport Expiry Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Emirates ID Number
Emirates ID Expiry Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
FIDE ID ( If any )
if any
Chess.com ID ( If any )
If any
E-mail

Confirmation Emailexample@example.com
Mobile Number
Format: 0000000000.
Father Tel. Number ( If Aplicaple )
your mobile number if you above 18 years Format: 0000000000.
Please upload your photo
Emirates ID ( Front )

Front page
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Emirates ID ( Back )

Back page
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Passport copy

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Photo (passport size)

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Note : Training is available only for the UAE nationality students between 5 to 16 years old
Signature
Please verify that you are human
Should be Empty:

Membership Form