CARROM
2022 – 2023
ENTRY FORM
(SINGLES) -
REVENUE DISTRICT : EDUCATION DISTRICT:
BLOCK NAME : ZONE :
HM Mobile No.: UDIS Code No. CATEGORY : Under - _____________ Boys / Girls
Name & Address of the School & School email ID: CATEGORY STANDARD BORN ON OR AFTER
UNDER 14 6 TH TO 9TH 01.01.2009
UNDER 17 6 TH TO 12 TH 01.01.2006
UNDER 19 6 TH TO 12 TH 01.01.2004
NAME OF THE PLAYER STD &
[Link] EMIS No. DATE OF BIRTH SIGNATURE OF THE STUDENT
(IN BLOCK LETTER) SEC
[Two copies of Individual Photo Identity form to be produced along with the Entry Forms]
TEAM MANAGER NAME & SIGN. (MOBILE NO.) HEADMASTER
CARROM
2022 – 2023
ENTRY FORM
(DOUBLES) -
REVENUE DISTRICT : EDUCATION DISTRICT:
BLOCK NAME : ZONE :
HM Mobile No.: UDIS Code No. CATEGORY : Under - _____________ Boys / Girls
Name & Address of the School & School email ID: CATEGORY STANDARD BORN ON OR AFTER
UNDER 14 6 TH TO 9TH 01.01.2009
UNDER 17 6 TH TO 12 TH 01.01.2006
UNDER 19 6 TH TO 12 TH 01.01.2004
NAME OF THE PLAYER STD &
[Link] EMIS No. DATE OF BIRTH SIGNATURE OF THE STUDENT
(IN BLOCK LETTER) SEC
[Two copies of Individual Photo Identity form to be produced along with the Entry Forms]
TEAM MANAGER NAME & SIGN. (MOBILE NO.) HEADMASTER
CARROM INDIVIDUAL PHOTO IDENTITY FORM
2022 - 2023
(For Individual Sports only)
1 Sports / Game CARROM (Singles/Doubles)
2 Age Group 14 / 17 / 19 – Boys / Girls
Passport Size
3
Name of the Student recent Photo
(in BLOCK LETTERS ) with School
4 Uniform
Standard & Section
(Attested
by Head Master/
a) EMIS Number
Principal with School
5 Seal)
b) Admission Number
c) Aadhaar Number
Date of Birth in figures
6
Date of Birth in words
Name of the School
7 with Address[ With PIN ]
/ School Seal.
8 Residential Address with
Contact Number
Parents Mobile No:
9 Name of the Zone
10 Name of the Education District
11 Name of the Revenue District
12 Name of the Division
1.
13 Identification Marks
2.
In English :
14 Signature of the Student
In Tamil :
I certify that the particulars furnished above have been verified with reference to the
Information registered in the school record and found correct.
TEAM MANAGER NAME & SIGN. (MOBILE NO.) HEADMASTER