DA Form 4878 Army Chess Tournament Application

DA Form 4878 - also known as the "Army Chess Tournament Application" - is a United States Military form issued by the Department of the Army.

The form - often mistakenly referred to as the DD form 4878 - was last revised on June 1, 2004. Download an up-to-date fillable PDF version of the DA 4878 down below or look it up on the Army Publishing Directorate website.

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ARMY CHESS TOURNAMENT APPLICATION
For use of this form, see AR 215-1; the proponent agency is OACSIM.
10 U.S. Code 3013.
AUTHORITY:
Identification of participants in the Army Chess Tournament.
PRINCIPAL PURPOSE:
Used to accept entries in the Army Chess Tournament and monitor participation. Information furnished
ROUTINE USES:
may be disclosed to any DOD component or part thereof, and upon request, to other Federal, State, or
local Government agencies in the pursuit of their official duties. Also, it may be disclosed to news media
in announcing contest participation and results. Finally, it may be used for other lawful purchases,
including law enforcement and/or litigation.
Disclosure is voluntary. If the requested information is not provided, the individual may be
DISCLOSURE:
precluded from participation in this Army Chess Tournament.
NAME (Last, First, MI)
RANK (By Name, i.e., Captain)
1.
2.
3.
4.
5.
MILITARY ADDRESS (Organization, Unit, State, P.O., APO, and
IMA REGION
DUTY TELEPHONE NO.
Zip Code)
(Autovon/Commercial)
6.
RECORD OF SIGNIFICANT CHESS ACTIVITY DURING THE LAST TWO YEARS (Use separate sheet, if necessary)
DATE
PLACE
EVENT
STANDING/PLACE
(a)
(b)
(c)
(d)
7.
U.S. CHESS FEDERATION MEMBERSHIP CARD IDENTIFICATION NUMBER AND STATE OF REGISTRATION
a.
b.
c.
U.S. CHESS FEDERATION
DATE OF RATING
DATE AND LOCATION OF LAST U.S. CHESS FEDERATION
RATING
TOURNAMENT
8.
DID
9.
I
INSTALLATION IDENTIFICATION (If applicable)
DID NOT PARTICIPATE IN AN INSTALLATION
QUALIFYING TOURNAMENT.
10.
11.
I
DID
IMA REGION IDENTIFICATION (If applicable)
DID NOT PARTICIPATE IN AN IMA REGION
QUALIFYING TOURNAMENT.
12. CURRENT DUTY ASSIGNMENT (Clerk, Medic, etc.)
13. SIGNATURE
14. DATE
DA FORM 4878, JUN 2004
DA FORM 4878, AUG 90 IS OBSOLETE
APD LC v1.00
ARMY CHESS TOURNAMENT APPLICATION
For use of this form, see AR 215-1; the proponent agency is OACSIM.
10 U.S. Code 3013.
AUTHORITY:
Identification of participants in the Army Chess Tournament.
PRINCIPAL PURPOSE:
Used to accept entries in the Army Chess Tournament and monitor participation. Information furnished
ROUTINE USES:
may be disclosed to any DOD component or part thereof, and upon request, to other Federal, State, or
local Government agencies in the pursuit of their official duties. Also, it may be disclosed to news media
in announcing contest participation and results. Finally, it may be used for other lawful purchases,
including law enforcement and/or litigation.
Disclosure is voluntary. If the requested information is not provided, the individual may be
DISCLOSURE:
precluded from participation in this Army Chess Tournament.
NAME (Last, First, MI)
RANK (By Name, i.e., Captain)
1.
2.
3.
4.
5.
MILITARY ADDRESS (Organization, Unit, State, P.O., APO, and
IMA REGION
DUTY TELEPHONE NO.
Zip Code)
(Autovon/Commercial)
6.
RECORD OF SIGNIFICANT CHESS ACTIVITY DURING THE LAST TWO YEARS (Use separate sheet, if necessary)
DATE
PLACE
EVENT
STANDING/PLACE
(a)
(b)
(c)
(d)
7.
U.S. CHESS FEDERATION MEMBERSHIP CARD IDENTIFICATION NUMBER AND STATE OF REGISTRATION
a.
b.
c.
U.S. CHESS FEDERATION
DATE OF RATING
DATE AND LOCATION OF LAST U.S. CHESS FEDERATION
RATING
TOURNAMENT
8.
DID
9.
I
INSTALLATION IDENTIFICATION (If applicable)
DID NOT PARTICIPATE IN AN INSTALLATION
QUALIFYING TOURNAMENT.
10.
11.
I
DID
IMA REGION IDENTIFICATION (If applicable)
DID NOT PARTICIPATE IN AN IMA REGION
QUALIFYING TOURNAMENT.
12. CURRENT DUTY ASSIGNMENT (Clerk, Medic, etc.)
13. SIGNATURE
14. DATE
DA FORM 4878, JUN 2004
DA FORM 4878, AUG 90 IS OBSOLETE
APD LC v1.00
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