Additional Chekel Request Fax
Please print this page and fill in the appropriate information
If you want to apply for permission to purchase additional chekels the following information
must be faxed or mailed to Brian Pollock, Office Manager, ICC:
The above information can be faxed directly to the ICC office: (412) 521-5575.
Or mailed to the ICC office:
- Credit Card information: Name as it appears on the card,
card number and expiration date. Name:_______________________
Credit card number:_______________________ Expiration date:____________
- Enclose a copy of the front and back of your credit card.
- On the enclosed copy include the handle name and signature of the credit card holder.
- Enclose copy of photo identification of the credit card holder.
- State clearly the amount of extra chekels you want to purchase. Amount:______________
Internet Chess Club
PO Box 5485
Pittsburgh, PA 15206