Application Form to Host a Regional Qualifier Tournament

Potential Tournament Organizers Must

Have read and understood the Eligibility Requirements for Tournament Organizers document.
Have a good reputation in the Yu-Gi-Oh! community.
Have enough gaming space in an Official Tournament Store, or have access to a venue that will accommodate the expected number
of players at the event.
Have the staff and equipment required to successfully organize and run a Regional Qualifier. This includes, but is not limited to,
computers, paper, printer, pens, paper cutters, etc.
Have enough knowledgeable judges and support staff to run the event, as outlined in the "Eligibility Requirements for Tournament
Organizers" document.

Application Instructions

Complete the following form and e-mail it to op-yugioh@devir.com. We are not accepting faxed applications.
Please title the email "[City, Country] Application for Regional Qualifier", where the city/country is the venue location.
Please complete all applicable fields. Incomplete applications may be rejected.
The application must be returned completed, in its editable form. Please do not alter the application.
TOs who do not own an Official Tournament Store should note "Independent TO" on the "Store Name" field.

Please fill out the following information about the applicant

Full Name
Phone Number w/Country & City Code
COSSY ID (Not Store ID)
E-Mail Address
Store Name
Store Seating Capacity
Store Address
Store City
Store State/Province
Store Zip/Postal Code
Store Country
Store Website
Estimated Regional Attendance
Contact E-Mail to be Posted
Contact Phone to be Posted
Requested Regional Start Time
Dragon Duel?
Do you wish
Win-A-Mat?
to host a:
Dawn of the Xyz Starter?

NICOLAS MORA BARRON

044 834 1040808

0400311491
niko_morab@hotmail.com

N&N TCG

60
ZONA CENTRO, 12 HIDALGO Y JUAREZ, GALA PLAZA, LOCAL 11

CD. VICTORIA

TAMAULIPAS
87000
MEXICO
NO TIENE

40
niko_morab@hotmail.com
044 834 1040808

12:00 pm

Yes
Yes
Yes

No
No
No

Please fill out the following information if your venue is not a Tournament Store
Venue Name
Venue Address
Venue City
Venue State/Province
Venue Zip/Postal Code
Venue Website
Venue Seating Capacity
Estimated Venue Cost (Amount / Currency)
Estimated Security Cost (Amount / Currency)

Please include details in section 1 on next page

Suggested date(s) for the event (DD/MM/YYYY)

First Choice
Second Choice
Third Choice
Fourth Choice
Fifth Choice
Sixth Choice

14/12/2013

15/12/2013
21/12/2013

22/12/2013

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Please provide the following additional information

1. Description of previous Organized Play experience. Include the game systems for which you have run events, name of the events,
number of players, and years of experience. Please include any additional information you feel necessary for us to be aware of.

2. List potential judge staff for the event. Include their previous Yu-Gi-Oh! judging experience (please include a valid e-mail address
for each judge). Please sure be sure to note who your Head Judge will be. All Judges at a Regional Qualifier must have passed the
Level 1 Rulings Comprehension exam AND must have joined the KDE Judge Program.
E-Mail Address
Position
Name
COSSY ID
Experience
Head Judge:
Floor Judge:
Floor Judge:
Floor Judge:
Floor Judge:
Floor Judge:
Floor Judge:
3. List available support staff for the event, along with their previous Organized Play experience.
Position
Name
COSSY ID
Experience
Scorekeeper:
Scorekeeper:
Event Staff:
Event Staff:
Event Staff:
Event Staff:
Event Staff:
4. Attach photos of the Tournament Store or potential venue. Include at least three (3) photos of the gaming area.
5. Attach a floor plan of the gaming area, noting the total amount of seating available.

This application is not a guarantee that the applicant will be granted a Regional Qualifier.
Applicant Name (Please Print)
Date (DD/MM/YYYY)

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