2004 Chess Journalists of America Awards
Cover Sheet

Category # ____________ Description _____________________________

Publication_____________________________________________________

or

Web URL ________________________________________________

Award Information:

Name __________________________________________

Address________________________________________

City, State, Zip __________________________________

CJA Membership:
(If different from the Award information)

Name __________________________________________

Address________________________________________

City, State, Zip __________________________________

1. Staple this cover sheet to the entry. If the material is too thick to staple the cover sheet to original and copies, then only staple cover sheet to the top item and rubber band with the rest.
   
   
2. Please type the cover sheet information if at all possible; print neatly otherwise.