ALL THE PLAYERS FOR OSSBA RANKING CHAMPIONSHIP, BHUBANESWAR, 2019 ARE REQUESTED TO REPORT AT SAHEED NAGAR INDOOR HALL AT 08:30 AM.

ALL ODISHA OSSBA RANKING CHAMPIONSHIP, SAHEED NAGAR, BHUBANESWAR, 2019

IF ANY QUERY PLEASE MAIL (shuttleodisha@gmail.com)

SL. NO.	ID. NO.	NAME	DIST.	EVENT
1	709	PATIL SIDHARTH RAJESH	BHUBANESWAR	BS U17
2	2135	BALI AMAN	KORAPUT	BS U17
3	2008	HAQUE M. ZEESHAN	BHUBANESWAR	BS U17
4	1233	MAHARANA ABHIJIT	BHUBANESWAR	BS U17
5	1229	MOHANTY AMRIT	BHUBANESWAR	BS U17
6	1354	KAR AMRIT KUMAR	BHUBANESWAR	BS U17
7	2010	KHAN TAHASIF	SAMBALPUR	BS U17
8	584	DAS AMANDEEP	BHUBANESWAR	BS U17
9	2019	SUDHAKAR ROHAN	SUNDERGARH	BS U17
10	83	PATTANAYAK AYUSH	MAYURBHANJ	BS U17
11	2005	DAS BIKASH	BHADRAK	BS U17
12	1693	MOHAPATRA KAUSHIK RANJAN	BHUBANESWAR	BS U17
13	1420	NAYAK AMAYA KUMAR	BALASORE	BS U17
14	1995	TRIPATHY AMRIT	CUTTACK	BS U17
15	2206	BEHERA ABHISHEK	ANGUL	BS U17
16	2132	TRIPATHY CHANDRANSU	KHURDHA	BS U17
17	2031	MOHANTY SHIV SANTOSH	KORAPUT	BS U17
18	767	DASH AYUSH	ANGUL	BS U17
19	1484	SAHU VINEET	CUTTACK	BS U17
20	1585	KANUNGO ABHIJIT	BHUBANESWAR	BS U17
21	1692	SWAIN MAHESWAR	BHUBANESWAR	BS U17
22	1721	SAHOO SUBHARANJAN	BHUBANESWAR	BS U17
23	1488	BISWAL YASHRAJ	BHUBANESWAR	BS U17
24	2176	SAHOO AMITESH KUMAR	BHUBANESWAR	BS U17
25	782	SAHOO ANUBHAB	CUTTACK	BS U17
26	1988	MAJHI ARYA	BALASORE	BS U17
27	1435	SAMAL GOPAL SRI CHANDAN	BHADRAK	BS U17
28	1431	ORAM SWARAJ	SUNDERGARH	BS U17
29	1232	MOHANTY PRIYANSHU	BHUBANESWAR	BS U17
30	2097	GURU JANMEJAYA	ANGUL	BS U17
31	1373	SAMANTA ANIRBAN	ANGUL	BS U17
32	1606	RAY BIBHUTI	SAMBALPUR	BS U17
33	1607	SWAIN SWASTIK	SAMBALPUR	BS U17
34	1289	PODDAR NANDISH	SAMBALPUR	BS U17
SL. NO.	ID. NO.	NAME	DIST.	EVENT
1	1233	MOHANRANA ABHIJIT	BHUBANESWAR	BD U17
1	1229	MOHANTY AMRIT	BHUBANESWAR	BD U17
2	1354	KAR AMRIT KUMAR	BHUBANESWAR	BD U17
2	709	PATIL SIDHARTH RAJESH	BHUBANESWAR	BD U17
3	1431	ORAM SWARAJ	SUNDERGARH	BD U17
3	1611	MAHANANDIA JITEN	SAMBALPUR	BD U17
4	1278	SAHARIA CHAYAN	SAMBALPUR	BD U17
4	1605	SAHIL MD	SAMBALPUR	BD U17
5	1435	SAMAL GOPAL SRI CHANDAN	BHADRAK	BD U17
5	1373	SAMANTA ANIRBAN	ANGUL	BD U17
6	2097	GURU JANMEJAYA	ANGUL	BD U17
6	2206	BEHERA ABHISHEK	ANGUL	BD U17
7	1323	VARMA VUPPALAPATI RISHEENDRA	RAYGADA	BD U17
7	1420	NAYAK AMAYA KUMAR	RAYGADA	BD U17
8	1232	MOHANTY PRIYANSHU	BHUBANESWAR	BD U17
8	1488	BISWAL YASHRAJ	BHUBANESWAR	BD U17
9	1606	RAY BIBHUTI	SAMBALPUR	BD U17
9	1607	SWAIN SWASTIK	SAMBALPUR	BD U17
SL NO	ID. NO.	NAME	DIST.	EVENT
1	2008	HAQUE M. ZEESHAN	BHUBANESWAR	BS U19
2	2010	KHAN TAHASIF	SAMBALPUR	BS U19
3	1558	PRADHAN KRISHNA CHANDRA	CUTTACK	BS U19
4	1289	PODDAR NANDISH	SAMBALPUR	BS U19
5	289	GHOSH ADITYA	SAMBALPUR	BS U19
6	1148	SAHOO PERSHURAM	CUTTACK	BS U19
7	1292	ARORA RITHIK	SAMBALPUR	BS U19
8	1988	MAJHI ARYA	BALASORE	BS U19
9	782	SAHOO ANUBHAB	CUTTACK	BS U19
10	1759	MOHANTY SUBHAM	BHUBANESWAR	BS U19
11	1721	SAHOO SUBHARANJAN	BHUBANESWAR	BS U19
12	1585	KANUNGO ABHIJIT	BHUBANESWAR	BS U19
13	1484	SAHU VINEET	CUTTACK	BS U19
14	19	PRADHAN SWAYAM PRAKASH	BHUBANESWAR	BS U19
15	398	MURMU PRAJESH	BHUBANESWAR	BS U19
16	588	PANDA DEBESH KUMAR	BHUBANESWAR	BS U19
17	767	DASH AYUSH	ANGUL	BS U19
18	83	PATTANAYAK AYUSH	MAYURBHANJ	BS U19
19	1665	BEHERA PRATIK KUMAR	KHORDHA	BS U19
20	2081	PUJARI SWAGAT	BHUBANESWAR	BS U19
21	2176	SAHOO AMITESH KUMAR	ANGUL	BS U19
22	1636	SAHOO ANKIT	SUNDERGARH	BS U19
23	2019	SUDHAKAR ROHAN	SUNDERGARH	BS U19
24	1533	PRUSTY HARI PRASAD	BHUBANESWAR	BS U19
25	584	DAS AMANDEEP	BHUBANESWAR	BS U19
SL. NO.	ID. NO.	NAME	DIST.	EVENT
1	1278	SAHARIA CHAYAN	SAMBALPUR	BD U19
1	1605	SAHIL MD	SAMBALPUR	BD U19
2	398	MURMU PRAJESH KUMAR	BHUBANESWAR	BD U19
2	588	PANDA DEBESH KUMAR	BHUBANESWAR	BD U19
3	19	PRADHAN SWAYAM PRAKASH	BHUBANESWAR	BD U19
3	1665	BEHERA PRATIK KUMAR	BHUBANESWAR	BD U19
4	1536	GOURAV BEHURA	PURI	BD U19
4	1148	SAHOO PARSHURAM	CUTTACK	BD U19
SL. NO.	ID. NO.	NAME	DIST.	EVENT
1	310	NAYAK SAI SATYASREE	BALASORE	MD
1	1343	NAYAK PRIYABRATA	BALASORE	MD
2	71	DAS SOUMEN SEKHAR	SUNDERGARH	MD
2	1187	MOHANTY PRAMEET KUMAR	SUNDERGARH	MD
3	1096	DAS WILLIAM	CUTTACK	MD
3	940	MALLICK ASHOK	CUTTACK	MD
4	506	MISHRA SANDEEP	KALAHANDI	MD
4	1065	MOHARANA	KALAHANDI	MD
5	51	CHAND GYAN	BHUBANESWAR	MD
5	52	RAUTROY MANAS RANJAN	BHUBANESWAR	MD
6	1719	KALO MOTILAL	BHUBANESWAR	MD
6	1722	BHOI ABHINASH KUMAR	BHUBANESWAR	MD
7	126	KRISHNA K. MURALI	BHUBANESWAR	MD
7	2	BANTHA RANJIT KUMAR	BHUBANESWAR	MD
8	1396	BEHURA BISHAL	PURI	MD
8	1536	BEHURA GOURAV	PURI	MD
9	158	MOHANTY AJIT KUMAR	CUTTACK	MD
9	157	RANA PRAMOD KUMAR	CUTTACK	MD
10	1388	MISHRA ASHIS	PURI	MD
10	763	MAJUMDAR ARIJEET	BALASORE	MD
11	1139	PATTNAYAK AVISEK	BHUBANESWAR	MD
11	175	JANI VIKRANT	BOLANGIR	MD
12	156	SATHPATHY CHITA RANJAN	BHUBANESWAR	MD
12	155	RAY AGNI RISHI	PURI	MD
13	2091	PATTANAYAK SURAJ	BHUBANESWAR	MD
13	1353	PARIDA BISWANATH	BHUBANESWAR	MD
14	167	SAHU ARABINDA	BOLANGIR	MD
14	172	NEPAL SURENDRA	BOLANGIR	MD
15	1678	DAS ASIRBAD	BHUBANESWAR	MD
15	2094	SAHOO RAJESH KUMAR	BHUBANESWAR	MD
16	1183	MOHANTY SMRUTI RANJAN	BHUBANESWAR	MD
16	12302	JENA SIDHARTH SEKHAR	CUTTACK	MD
17	856	JOHN JOSHUA	ANGUL	MD
17	102	SAHOO SWADESH RANJAN	ANGUL	MD
18	1322	MOHANTY ABINASH	ANGUL	MD
18	83	PATTNAYAK AYUSH	MAYURBHANJ	MD
19	1243	MAHARANA BIJAYA KUMAR	BHUBANESWAR	MD
19	2136	PATTNAIK ASUTOSH	KHORDHA	MD
20	2165	MOHANTY GYANA RANJAN	BHUBANESWAR	MD
20	2137	SWAIN SARADA	BHUBANESWAR	MD
SL. NO.	ID. NO.	NAME	DIST.	EVENT
1	2148	MUNDARY SUNANI	SUNDERGARH	WS
2	2147	PANDA SMITA RANI	SUNDERGARH	WS
3	1285	DAS PRASHANSA	SAMBALPUR	WS
4	1702	BISWAL ROSHNI	CUTTACK	WS
5	2007	MOHARANA BHAGYA LAXMI	BHUBANESWAR	WS
6	1486	MOHANTY SHEBASHREE	BHUBANESWAR	WS
7	1608	BISWAL SHREYA	SAMBALPUR	WS
8	1338	DEY GEETASHREE	SUNDERGARH	WS
9	499	BIROK KRISHNIKA	SUNDERGARH	WS
10	2035	PRIYADARSHI ISHITA	SUNDERGARH	WS
11	180	KURREY AKANKSHA	SUNDERGARH	WS
12	1646	PANDA ANANDIYA	SUNDERGARH	WS
13	2018	TOPPO VISHAKHA	SUNDERGARH	WS
14	1644	BIROK ANSHIKA	SUNDERGARH	WS
15	1535	ROUT HARSHITAA	BHUBANESWAR	WS
16	1584	GAYATREE BISWABANDITA	BHUBANESWAR	WS
17	2021	LAXMI PRIYA DARSHINI	BHUBANESWAR	WS
18	73	PATI APRAJITA	SUNDERGARH	WS
19	576	ACHARYA ANUSKHYA	BHUBANESWAR	WS
20	1588	MOHANTY JAYASHREE	BHUBANESWAR	WS
SL NO.	ID. NO.	NAME	DIST.	EVENT
1	2018	TOPPO VISHAKHA	SUNDERGARH	WD
1	1644	BIROK ANSHIKA	SUNDERGARH	WD
2	499	BIROK KRISHNIKA	SUNDERGARH	WD
2	180	KURREY AKANKSHA	SUNDERGARH	WD
3	2035	PRIYADARSHI ISHITA	SUNDERGARH	WD
3	1646	PANDA ANANDIYA	SUNDERGARH	WD
4	1584	GAYATREE BISWABANDITA	BHUBANESWAR	WD
4	2021	LAXMI PRIYA DARSHINI	BHUBANESWAR	WD
5	576	ACHARYA ANUSKHYA	BHUBANESWAR	WD
5	1588	MOHANTY JAYASHREE	BHUBANESWAR	WD
6	73	PATI APRAJITA	SUNDERGARH	WD
6	1535	ROUT HARSHITAA	BHUBANESWAR	WD
7	572	SAMAL YASHASHREE	BHUBANESWAR	WD
7	754	KUMARI NANDINI	BHUBANESWAR	WD
8	1702	BISWAL ROSHNI	CUTTACK	WD
8	2007	MOHARANA BHAGYA LAXMI	BHUBANESWAR	WD

THE FOLLOWING PLAYERS HAVE CONFIRMED THEIR ENTRIES TO PLAY THE FORTH COMING MASTER NATIONAL AT GOA FROM 28TH JAN TO 03 FEB 2019.

THOSE WHO HAVE APPLIED FOR NEW BAI ID, THEIR ENTRY DEPEND UPON THE CONFIRMATION OF BAI ID. FOR ANY QUERY PLEASE CONTACT IN OUR OFFICE BY THIS NUMBER 9437331931 (10:00 AM TO 07:00 PM)

	SL. NO.	ID NO	NAME	EVENT
QUALIFYING	1	23191	BHABESH SETH	VS 35+
QUALIFYING	2	APPLIED	K. C. PATTNAIK	VS 35+
QUALIFYING	3	APPLIED	SANGRAM KUMAR MALLICK	VS 35+
	SL. NO.	ID NO	NAME	EVENT
QUALIFYING	1	20050	SWADHIN KUMAR MISHRA	VD 35+
QUALIFYING	1	20048	SUDHIR KUMAR MISHRA	VD 35+
QUALIFYING	2	APPLIED	K. C. PATTNAIK	VD 35+
QUALIFYING	2	APPLIED	SANGRAM KUMAR MALLICK	VD 35+
	SL. NO.	ID NO	NAME	EVENT
MAIN DRAW	1	107	BIBHAS KUMAR	VS 40+
MAIN DRAW	2	APPLIED	BIJAY KUMAR MAHARANA	VS 40+
	SL. NO.	ID NO	NAME	EVENT
MAIN DRAW	1	107	BIBHAS KUMAR PARIDA	VD 40+
MAIN DRAW	1	17197	SIBA PRASAD DAS	VD 40+
	SL. NO.	ID NO	NAME	EVENT
MAIN DRAW	1	5478	MD HASSIM	VS 45+
MAIN DRAW	2	9042	RANJIT KUMAR SAHU	VS 45+
	SL. NO.	ID NO	NAME	EVENT
QUALIFYING	1	9041	MAHESH KUMAR KUKERAJA	VD 45+
QUALIFYING	1	APPLIED	S K YUNUS	VD 45+
QUALIFYING	2	20049	SURENDRA KU NAIK	VD 45+
QUALIFYING	2	20047	SUBASH KU MISHRA	VD 45+
	SL. NO.	ID NO	NAME	EVENT
MAIN DRAW	1	14497	SAMIR KUMAR SAHOO	VS 50+
MAIN DRAW	2	9043	HEMANT KUMAR MISHRA	VS 50+
	SL. NO.	ID NO	NAME	EVENT
QUALIFYING	1	17199	TRINATH DEHURY	VD 50+
QUALIFYING	1	17189	BIRAJA PRASAD KAR	VD 50+
QUALIFYING	2	14497	SAMIR KUMAR SAHOO	VD 50+
QUALIFYING	2	9043	HEMANTA KUMAR MISHRA	VD 50+
QUALIFYING	3	17205	SUBHASIS SAHU	VD 50+
QUALIFYING	3	APPLIED	SANJAYA KR. SAHU	VD 50+
	SL. NO.	ID NO	NAME	EVENT
QUALIFYING	1	9037	GURMIT SINGH	VS 55+
QUALIFYING	2	5517	GUNANIDHI SETHI	VS 55+
QUALIFYING	3	5518	PRATAP KUMAR KHADANGA	VS 55+
	SL. NO.	ID NO	NAME	EVENT
QUALIFYING	1	9037	GURMIT SINGH	VD 55+
QUALIFYING	1	5517	GUNANIDHI SETHI	VD 55+
QUALIFYING	2	28359	SUDHAKAR SAHOO	VD 55+
QUALIFYING	2	23194	SADASIVA PRADHANI	VD 55+
	SL. NO.	ID NO	NAME	EVENT
MAIN DRAW	1	28603	JAMES KUJUR	VS 60+
MAIN DRAW	2	5480	MANORANJAN DAS	VS 60+
	SL. NO.	ID NO	NAME	EVENT
QUALIFYING	1	28603	JAMES KUJUR	VD 60+
QUALIFYING	1	5480	MANORANJAN DAS	VD 60+
QUALIFYING	2	9038	SAMIR KUMAR GHOSH	VD 60+
QUALIFYING	2	17191	RAMA CHANDRA SETHI	VD 60+
	SL. NO.	ID NO	NAME	EVENT
MAIN DRAW	1	17206	PRABODH KUMAR PAL	VS 65+
MAIN DRAW	2	9038	SAMIR KUMAR GHOSH	VS 65+
	SL. NO.	ID NO	NAME	EVENT
MAIN DRAW	1	17191	RAMA CHANDRA SETHI	VD 65+
MAIN DRAW	1	17206	PRABODH KUMAR PAL	VD 65+

ALL ODISHA JUNIOR BOYS’ (UNDER-17 & 19), WOMEN’S AND MEN’S DOUBLES BADMINTON RANKING TOURNAMENT SCHEDULED TO BE HELD FROM 8TH TO 10TH FEBRUARY, 2019 AT ODISHA SAI REGIONAL BADMINTON ACADEMY, SAHEED NAGAR, BHUBANESWAR ORGANISED BY ODISHA STATE SECRETARIAT BADMINTON ASSOCIATION (OSSBA)

ALL ODISHA JUNIOR BOYS’ (UNDER-17 & 19), WOMEN’S AND MEN’S DOUBLES  BADMINTON RANKING TOURNAMENT SCHEDULED TO BE HELD FROM 8^TH TO 10^TH FEBRUARY, 2019 AT ODISHA SAI REGIONAL BADMINTON ACADEMY, SAHEED NAGAR, BHUBANESWAR ORGANISED BY ODISHA STATE SECRETARIAT BADMINTON ASSOCIATION (OSSBA)

 Men & Women, Boys (U-17, U-19)

          

The State Ranking Championship for   Men & Women, Boys (U-17, U-19) and will be held from 8^th  to  10^th  February-2019 at Saheed Nagar SAI indoor Hall, Bhubaneswar

The Following guidelines are to be implemented during the conduct of the championship.

1:0       DATES OF THE TOURNAMENT:  8^th  to  10^th  February-2019

1:1       The championship will be organized as follows:

Venue :Saheed Nagar SAI indoor Hall, Bhubaneswar

 Players: Only registered players of Orissa State Badminton Association are eligible to participate. The participants should submit the age certificate duly attested & along with BAI Age Pro-forma After verifying all the papers, OSBA ID will be issued and the players will use the state ID for giving entries in the championship. Without state ID the entries shall not be entertained.

Events :, U17 BOYS SINGLES, U17 BOYS DOUBLES,U19 BOYS SINGLES, U19 BOYS DOUBLES,WOMENS SINGLES, WOMENS DOUBLES, MEN DOUBLES

Limitation: There should be minimum eight no entries for any event to be conducted. A player can participate in maximum two events both in QF & Main rounds.

1:2 Championship:

The championship will be conducted in two rounds i.e qualifying round and main draw.              

Tournament Committee may not conduct Qualifying Draw of any event/resize the Main Draw depending upon the entries of that event. The players qualified in the qualifying round will participate in the main draw along with the list of players released by OSBA.

The players, who are selected for main draw of an event, may have the option to participate in the qualifying draw of other events.

2:0 The programs for state championship are as mentioned below:

2.1 All the players, who like to participate in the tournament in any event, will mention their state ID during submission of entries. No entry will be accepted without State ID.

Players shall check and confirm that their names are there in the PREVIOUS ID list. Any alteration required may be intimated to undersigned by 20th^th Jan,2019 in writing or by mail to shuttleodisha@gmail.com.

2.2 The date lines are as below:

Dates	Time	Details
29th Jan2019	4pm	Last date of Receipt of entries with entry fees
1st  Feb-2019	4pm	Release of M&Q list
2nd  Feb-2019	4pm	Last date for any withdrawal
5th Feb-2019	4pm	Release of fixture for qualifying round / Main Draw
8th Feb-2019	9am	Qualifying matches / Main Draw Matches
10thFeb-2019		Finals

3:0 Eligibility :

3:1 The tournament will be organized in following age groups only having the specified eligibility criteria.   

  

GROUP	AGE AS ON RFERENCE DATE	BORN ON OR AFTER
MASTERS	U17 Boys	1ST JAN, 2003
	U 19 Boys	1ST JAN, 2001

3:2 No entry shall be accepted unless the player has been allotted a Player ID and has submitted the age proof as per the BAI Competition Regulations.If needed there will be medical test by doctors for verification of age.The players who have not given new BAI format are requested to submit fresh duly filled forms.The new guideline of BAI for age fraud will be applicable.A three member committee will verify the age related papers on reporting by players.

3:3 At the close of entries, the organising committee will provide with the list of participants.

3:4 Once the entries are duly verified by the Secretary, the complete list in a computer file (MS Excel File) shall be sent to organising Committee. OSBA will release the list of seeded players as per OSBA Ranking.

3:5 Once approved, the list of participants in order of strength will be displayed on notice board of OSBA as well in thehttp://odishabadminton.blogspot.in.  It shall be the responsibility of the Affiliated Unit and the players to ensure that all the entries send by them appear in the M & Q List. After the Last Date for withdrawals without penalty, no complaints shall be entertained for miss out of any entry. The OSBA is not responsible for any omissions or correction of names.

3:6 After fixture is released, any player withdrawing from any event or giving walkover shall be scratched from other event.  

3:7 If necessary there shall be a medical examination of age group of players, whose age proof is doubtful. Medical examination will be conducted by a panel of doctors appointed by organizing committee.

3:8.Palyer shall report before 30 mins of their timing in fixture, or else after 5 mins of waiting of the given time in fixture the referee shall give walkover to opponent.

3;9.Doubles partner must wear Same color Clothing as per BWF rules.

4:0  PROTEST :

4:1 The protest of any kind will have to accompanied by a protest fee of Rs1000.00 .Protest has to made before the match or within one hour of the completion of the match and shall be addressed to the Secretary in writing.

5:0 ENTRY FEES:

5:1 The  entry fees that can be collected from players shall be:

Singles event all category	Rs.400 per player
Doubles event all category	Rs.800 per pair

 5:2 The Entry fees may be sent to treasurer OSBA in shape of DD payable at Cuttack in favour of “ORISSA STATE BADMINTON ASSOCIATION”, without which entries are not accepted. The same may be sent to Mr. KAILASH CH.PATI, Trasurer, Orissa State Badminton Association, C/O VISIONEX,B-1CDA Market Complex ,College Squire,Cuttack-753003.Ph:9437331931

.

6:0  Boarding & Lodging :

6:1 The Orissa State Secretariat Badminton Association shall provide to the Participants coming beyond 60 Kms free accommodation at their own request nearby the venue from 7^th evening to 12^th (morning) of February, 2019

6:1:1: For Food and Lodging contact to-Bareshnath Pradhan-ph.9437230573

6:1:2 Player may contact to Organizing  Committee-ChittaRanjan Rout(ph.8249109824), SansakSekhar Mohapatra (ph.9437129811)

6:2. All the players are advised to report on 8-1-2019 at 7AM And they may collect their food coupon.

7:0 Age Verification:

Association may verify the age by a Doctors’ committee and reject the entries if found inappropriate for the event applied for. They cannot be accommodated to participate in any event.

8:0 Rights to amend.

8.1 Association reserves right for any changes in championship rules &regulations/ schedule etc without assigning any reason.

We shall be glad to clarify on any of the above matter and assure you to extend our full support and cooperation in smooth and successful of the tournament.

Wishing you every success!

            Yours Sincerely

      

             Pradip Mohanty

              Hon.Secretary

Orissa State Badminton Association

Keonjhar Colony,kanika Chhak

          Cuttack-753008

        Ph-09861032965

Email:shuttleodisha@gmail.com

the http://odishabadminton.blogspot.in/

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                                                                ENTRY FORM

                     ORISSA STATE    MASTERS BADMINTON CHAMPIONSHIP-2018 

NAME:

STATE ID:

EVENTS :

PARTNERS NAME WITH  STATE ID:

AMOUNT PAID:

DD NO:                            DT:

TEL no:

                                                                                                                       SIGNATURE

(FOR EACH ENTRY A SEPARATE FORM SHOULD BE USED)

WITHOUT ENTRY FEE ALONG WITH ENTRY FORM  NO ENTRY WILL BE ACCEPTED

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