BHARATHIYAR DAY & REPUBLIC DAY COMPETITION 2017 - 2018

SILAMBAM - ENTRY FORM – Under-14 BOYS

Name of the School: Zone:

Educational District: Division:

Weight
S.No. Name of the Student Std. EMIS No. Date of Birth Signature of the Students
Categories
18 & ABOVE TO
1 BELOW 20

20 & ABOVE TO
2
BELOW 25

25 & ABOVE TO
3
BELOW 30

30 & ABOVE TO
4 BELOW 35

35 & ABOVE TO
5
BELOW 40

40 & ABOVE TO
6 BELOW 50
[Two copies of Individual Photo Identity to be produced along with the Entry Forms]

TEAM MANAGER HEADMASTER

 BHARATHIYAR DAY & REPUBLIC DAY COMPETITION 2017 - 2018
SILAMBAM - ENTRY FORM – Under-17 BOYS
Name of the School: Zone:

Educational District: Division:

Weight
S.No. Name of the Student Std. EMIS No. Date of Birth Signature of the Students
Categories
25 & ABOVE TO
1 BELOW 30
30 & ABOVE TO
2 BELOW 34
34 & ABOVE TO
3 BELOW 38
38 & ABOVE TO
4 BELOW 42
42 & ABOVE TO
5
BELOW 46
46 & ABOVE TO
6
BELOW 50
50 & ABOVE TO
7
BELOW 54
54 & ABOVE TO
8
BELOW 60
60 & ABOVE TO
9
BELOW 70
[Two copies of Individual Photo Identity to be produced along with the Entry Forms]

TEAM MANAGER HEADMASTER

 BHARATHIYAR DAY & REPUBLIC DAY COMPETITION 2017 - 2018
SILAMBAM - ENTRY FORM – Under-19 BOYS
Name of the School: Zone:

Educational District: Division:

Weight
S.No. Name of the Student Std. EMIS No. Date of Birth Signature of the Students
Categories
35 & ABOVE TO
1 BELOW 40

40 & ABOVE TO
2
BELOW 45

45 & ABOVE TO
3
BELOW 50

50 & ABOVE TO
4 BELOW 55

55 & ABOVE TO
5
BELOW 60

60 & ABOVE TO
6
BELOW 65

65 & ABOVE TO
7 BELOW 70

70 & ABOVE TO
8
BELOW 80
[Two copies of Individual Photo Identity to be produced along with the Entry Forms]

TEAM MANAGER HEADMASTER

 BHARATHIYAR DAY & REPUBLIC DAY COMPETITION 2017 - 2018
SILAMBAM - ENTRY FORM – Under-14 GIRLS
Name of the School: Zone:

Educational District: Division:

Weight
S.No. Name of the Student Std. EMIS No. Date of Birth Signature of the Students
Categories
18 & ABOVE TO
1
BELOW 20

20 & ABOVE TO
2
BELOW 25

25 & ABOVE TO
3
BELOW 30

30 & ABOVE TO
4
BELOW 35

35 & ABOVE TO
5 BELOW 40

40 & ABOVE TO
6
BELOW 50
[Two copies of Individual Photo Identity to be produced along with the Entry Forms]

TEAM MANAGER HEADMASTER

 BHARATHIYAR DAY & REPUBLIC DAY COMPETITION 2017 - 2018
SILAMBAM - ENTRY FORM – Under-17 GIRLS
Name of the School: Zone:

Educational District: Division:

Weight
S.No. Name of the Student Std. EMIS No. Date of Birth Signature of the Students
Categories
25 & ABOVE TO
1
BELOW 30
30 & ABOVE TO
2
BELOW 34
34 & ABOVE TO
3
BELOW 38
38 & ABOVE TO
4
BELOW 42
42 & ABOVE TO
5
BELOW 46
46 & ABOVE TO
6
BELOW 50
50 & ABOVE TO
7 BELOW 54
54 & ABOVE TO
8 BELOW 60
60 & ABOVE TO
9 BELOW 70
[Two copies of Individual Photo Identity to be produced along with the Entry Forms]

TEAM MANAGER HEADMASTER

 BHARATHIYAR DAY & REPUBLIC DAY COMPETITION 2017 - 2018
SILAMBAM - ENTRY FORM – Under-19 GIRLS
Name of the School: Zone:

Educational District: Division:

Weight
S.No. Name of the Student Std. EMIS No. Date of Birth Signature of the Students
Categories
35 & ABOVE TO
1
BELOW 40

40 & ABOVE TO
2 BELOW 45

45 & ABOVE TO
3
BELOW 50

50 & ABOVE TO
4
BELOW 55

55 & ABOVE TO
5 BELOW 60

60 & ABOVE TO
6
BELOW 65

65 & ABOVE TO
7
BELOW 70

70 & ABOVE TO
8 BELOW 80
[Two copies of Individual Photo Identity to be produced along with the Entry Forms]

TEAM MANAGER HEADMASTER

 INDIVIDUAL PHOTO IDENTITY FORM FOR
SILAMBAM COMPETITION 2017 - 2018
(For Individual Sports only)
Weight
1 Sports / Game SILAMBAM Category { }
Passport size
2 Age Group 14 / 17 / 19 – Boys / Girls Photograph dully
Attested by the
Name of the Student
3 Principal /
(in BLOCK LETTERS )
Headmaster with
4 Standard & Section Stamp

5 EMIS - number

6
Date of Birth in figures - -
Date of Birth in words

Name of the School

with Address [ With
7
PIN ]
/ School Seal.

Residential Address
8 with
Contact Number
Parents Cell Number

9 Name of the Zone

10 Name of the Edn. Dist.

11 Name of the Rev. Dist

12 Name of the Division

1.
13 Identification Marks
2.

In English :
14 Signature of the Student
In Tamil :

Note: 3 Attested copies of Birth Certificate or Bonafide Certificate for up to Std X / or / X mark sheet for
under 19 to be enclosed along with the Eligibility Form.
I certify that the particulars furnished above have been verified with reference to the
Information registered in the school record and found correct.

P.D / P.E.T Headmaster