5'h 2015- 16-28 2016hockeyindia.org/images/stories/2017/12/5th-hockey-indi… · ·...

5'h Hockey India Senior Men National Championship 2015- Saifai, Uttar Pradesh, 16- 28 April 2016

Participation Certificates Details

Serial Number allotted for Senior Men (B & A Division)- 16015- 16960 {945 nos)

1. Tripura Hockey

2. Hockey Kerala

3. Assam Hockey

4. Hockey Uttarakhand

5. Hockey Jammu & Kashmir

6. Hockey Rajasthan

7. Hockey Gujarat

8. Vidarbha Hockey Association

9. Hockey Andaman & Nicobar

10. Sashastra Seema Bal

11. Hockey Puducherry

12. Chhattisgarh Hockey

13. Dadra & Nagar Haveli

14. Bengal Hockey Association

15. Central Reserve Police Force

16. Hockey Bihar

17. Hockey Madhya Pradesh

18. Major Port Sports Control Board

19. Manipur Hockey

20. Delhi Hockey

21. Central Industrial Security Force

22. Hockey Himachal

16016-16034 (20 nos) (18 Players+ Manager+ Coach)

(Cancel16015)

16036-16055 {20 nos) (18 Players+ Manager+ Coach)

16056-16075 {20 nos) {18 Players+ Manager+ Coach)


(Cancel16078) (Replaced 16438)

16096- 16099 & 16201 - 16216 {20 nos)

{18 Players+ Manager+ Coach)

16217 -16236 {20 nos) {18 Players+ Manager+ Coach)

16237-16256 (20 nos) {18 Players+ Manager+ Coach)







(Cancel16356 & 16357) (Replaced 16358 & 16359)

16378-16397 {20 nos) (18 Players+ Manager+ Coach)




16459 -16477 {18 no.s) {16 Players+ Manager+ Coach)

(Damage Certificate 16476)

16478-16496 {19 nos) {18 Players+ Manager)


16517 -16536 (20 nos) (18 Players+ Manager+ Coach)

16537 -16555 {19 nos) {18 Players+ Manager)


23. Hockey Chandigarh 16556-16574 (19 nos) (18 Players+ Manager)

24. Hockey Patiala 16575 -16594 {20 nos) {18 Players+ Manager+ Coach)

25. Namdhari XI 16595 -16614 {19 nos) {18 Players+ Manager)

(Cancel16613)

Total no. of cancelled certificates - 06 nos+ 01 nos damage

Serial Number allotted for Senior Men (A Division)

26. Sports Authority of India

27. Association of Indian Universities

28. C. A. G

29. Hockey Andhra Pradesh

30. Food Corporation of India

31. Hockey Unit of Tamil Nadu

32. Hockey Bhopal

33. Hockey Karnataka

34. Hockey Punjab

35. Services Sports Control Board

36. Hockey Odisha

37.HockeyJharkhand

38. Madhya Pradesh Hockey Academy

39. The Mumbai Hockey Association Ltd -

40. Hockey Maharashtra

41. Hockey Haryana

42. Hockey Gangpur Odisha











16796- 16815 (20 nos) (18 Players+ Manager+ Coach)


16836- 1685S (20 nos) (18 Players+ Manager+ Caoch)


168.76-16895 {20 nos) (18 Players+ Manager+ Coach)




Total no. of cancelled certificates - 01 nos

Remaining Extra Certificates - 16955- 16960 {6 nos)

Participation Bronze Certificates Details Serial Number allotted for Senior Men (Bronze):- 16961- 16986 (26 nos)

43. Air India Sports Promotion Board- 16961- 16980 (20 nos) {18 Players+ Manager+ Coach)

Remaining Extra Certificates - 16981- i6986 (5 nos)

Participation Silver Certificates Details

Serial Number allotted for Senior Men (Silver):- 16987- 17012 (26 nos)

44. Uttar Pradesh Hockey 16987 -17006 {20 nos) (18 Players+ Manager+ Coach)

Remaining Extra Certificates - 17007 -17012 (6 nos)

Participation Gold Certificates Details

Serial Number allotted for Senior Men {Gold}:- 17013- 17038 (26 nos)

45. Railway Sports Promotion Board 17013 -17032 (20 nos) (18 Players+ Manager+ Coach)

Remaining Extra Certificates - 17033- 17038 {6 nos)

HOCKEY INDIA

ENTRY FORM

C<lMI'I·:TITIClN:

lli\TI' OF COMI'FTITION· oth -2n'11 March.2015 ST/\TF ___ -_!~~-i.E~~~~! ...... .

,-- - ---- ------· PLA YI,RS

Shirt Family Name First Nmnc Dale of Birth I locke~ lmlw No I PRIN"Il'D- II'RINTED-Ill.OCK Falhcr"s Name

I- 32 BLOCK lEITERS (ddlnun/yyyyl IIJ CanJ No.

LE'ITERSI ---- I -,r SHAHili\J MOHD MOIID Mli.IEEB :ll/07/ I 1J'J 1 ---rco/J_--1 ---

" RI7:Tifi6R; yA VINIT l(llMAR VliEil SIN< ill Ri\.IORIY i\ 30/06/1995 Gor ' ( os Klli\N fJJD}f:J.' Pll~HA'IJ i\.1/\Z AHMAD Klli\N 04/0(JI9<J2 .LtoiQ,_ j -BiiiM -

- ----- ---

IS Yi\1>/\V SUR Y i\BIIi\N Y AD/\ V 12/0711994 -tfbC!LLJ - . --------- -------~~~ '>Hf>kH"It. S/JVI!J} g U"b HF; N f.I·N llAMA SHANKAR SINGH 05/10/1995 0?-1 ;

--- ----- ----'~ GUPTA i\NKIT .IACiANNAT GlJPTA 14/0G/1992 /60'2-/ -l>4 i\SIF "MOl Ill MOIID 11/\NEEF I 0/07/1995

_::}k-g~}l <>3 MTSJIRA MADAN KUMAR KAMLESH MISHRA 1 CJ/0?./ 19S(l -----------

SIIAIIIIJ-A'i!i,AAI> KHAN(Y-<) ..

~ 07 KHAN £O,<i41!3 AIIMAil 02/1111988 r~o2.tt-' 1-- I 3 i\SHEESH Slllli·:SII Kl IMAR

-~-

Kl!Mi\R 02/04/1 1)X') /uv 2'r.

~ 1-- / () S r!l )ll\ Ill I J)fNT'Sll I<:U Mil R PAllAS Ni\·r:rr... . ( C.) 12/12119')4 /bol6 ·--···-· or- SINtill _t;J.PH~i':~KT IM/\R RAil I 11·: S H.Y AJ'lSIN<; II 05/07/ I 'JKX /bO?.I} ---·

~~ -6;J._ lSI AM NOOR Ill. MOJID. ISLAM 12/1211094 o'l-2i - --·--

Si\N.Ti\ Y KT IMAR 04/01/1996 _[~'1_ ~~ CIIAUIJHAJ( Y i'RASHANI _, __ . --- -------

11 lllli\RDWAJ Alli!ISHEK .1/\0VFFR STT/\RM/\ 27/0.1/1998 /10 0 D - ------------- ----

Ol KIT AN SAAIJ U LLAJ I Si\IF IJLI.i\H Kl-li\N &-·\( 17/111199.~ ------ ----~ --

01 KHAN TITW/\N MOITil NASEI·:M KIIAN O't!,/07/11)~>3 --.------------

Ill Sf\ HNI 1<,\E;)!h N LA\.. llEVNi\TII SIIANI G-,, II 05/0CJ/l 'J'J..j . ----

Sun.:sh Shwmu Co.1ch· FAIH IAT AI.! KIIAN

oqao74Ho ~J (lto}.$5~-----oq?.'"J_!S7'f~.rq 6o:?,+ TI·:AM COI.OIIIlS AI.Tl'RN/\TIVE COI.OIIRS

Shirt Je.. (. '])

Shorts: fJ, LA c. J<

S"cks: l$LM.J< (foall-;ccpcr shirt ~~EEN

Shirl:

Shorts:

Socks·

Goalkeeper shirt SLlJE'

/bCJ ':!:,( 4 \6 o'!.. 'l- i f 6o '1~

I

(Must compnsc ~.JJflCrcnt colour In both pnmary ;md alternate colour or shirt)

(Must comprise different colour to hoth primary tmd altcmatc colour i of shirt)

One sctmu.st comprise at least RO% singlt.: colour per piece t roalkccpcr shirt must Cl1n1Jlrisc difli.:rcnt colour to hnth pnrnary and alternate colour of shirt.

1 Name Ja~1mta Bhm\lnik

j l'ositinn:(il.."ncr:Jl Sccrclaf\ I - .

natc~-t (~llr-[,~"' ~~ l~ 1\,C~v '""·;: L . . ·~o(iy. General Secretary,

STg.naturc T . H ckey nour.a o . .

ENTRY FORM COMPETITION : 5th Hockey India Senior Men National Championship 2015 (Div B!.

DATE OF COMPETITION : 06 April- 20 April 2015 STATE: KERALA

Shirt No

1-32

PLAYERS

Family Name First Name [PRINTED- Date of Birth [PRINTER • Father's Name

BLOCK LETTERS] BlOCK lETTERS] (ddlmmlyyyy)

I 1 bo':$f£<)({,!<) VIVEKS SOMAN S 30.05.1990

Hockey India ID Card No.

~~ r-1~7_,~~~~0~1~,~~--~J~H~AR~I~P~RAS~A_TH ____ ~P~JA~Y~A~RA~M_A~N~-----+~1=2-~01~.1~9~9~0-+-------------------1 i~r-72-t+'h~~~~~~~~~-+.A~D~A~RS~E~S~----_,~sU~D~A~RS~A~N~AN~~---r-=18~.0=3~.1~99=0~r-----------------~ -'1 3 I ~ (') 'l C RATHIN 0 R P K RAGHUNATH 09.05.1995 ~~r-~4_,-~/'~n'~~~0--ES~AN~D~E=E~P.7s.~P------ES~AD~M~IV~A7.N~.K~-----+~05~.~09~.1~9=974-+--~P~l~I~K=ER~I~0~1=69~1~1~2701~4~-1 r;J 6 A DAVOOD ABOOBAKER

s I o_..,J MAHEEN ABooaAKER

f 6 I tt4-'l MUHAMMED RISHAD Ill HMSAIN M 5{" 7 . f) 4-S AIJU P A!'! DREWS C ANDREWS

q 8 I 0-+4- PRAVEEN KUMAR G l J GOPI

I I 9 I (, tl~'\--.!' ~OHNSON R ROBERT P C 10 '1 I)Q 4".!) GEORGEJ V JOSEPH G

~ 11 I : 0 4-! FARIS MON.P HAMEED.P \ ':f 12 , 1> 04 BIBIN BABY K P BABY

10 13 t;.0-4J.q RATHEESH V R RAJENDRAN V

3 14 05:_0 ABIJITH.B BALACHANDRAN NAIR

\'2- 15 /60~/ JITHUSMI TASMI

~ ~ 16 l/t 1> C'Z..( G,/9 NAIMUDEEN A C AU

\3 18 16 D.5 ') KIRAN KUMAR G l J GOP!

17.01.1994

05.12.1993

18.02.1995

30.11.1977

30.01.1985

14.03.1991

606.1995

22.05.1994 02.05.1989

10.05.1994

13.02.1994 10.05.1981

02.12.1988

Pl I KER I 01684 I 2014

Pl I KER I 01255 I 2014

Pl I KER I 01682 I 2014

Pl I KER I 01679 I 2014

Pl I KER I 01692 I 2014

. .ll 'ream Manager: PRASANTH.D.A cE-<tranik:.Pt:i , ~f TEAM COLOURS 1\ b () 5 ~)

Coach: JEFFRY RAJESH PINHERO ~ OCf6330"J3!1

~\W SKY BLUE 1: Shorts: BLACK Socks: NEAVY BLUE Goalkeeper shirt: NEAVY BLUE

Shirt: l\ 6 tl ~ J.t") Shirt: ALTERNATIVE COLOURS

Shorts: Socks: Goalkeeper shirt:

(Must comprise different colour to both primary and alternate (Must comprise different colour to both primary colour of shirt) and alternate colour of shirt) One set must compirse at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both primary and

alternate colour of shirt.

Name: S.AFSAR AHAMED

Position :GENERAL SECRETARY

Note: It is mandatory for the participating team t which they will be penalized. Also, it Is mandatory

Date: 02:04:2015

Signature:

lth correct shirt numbers and colours, falling bo'lo~w·o sets of Socks (to avoid any colour clash)

.... S.A.FSAR AHAMED) GEN:SECRETARY J KERALA HOCKEY i

_______ '1

HOCKEY INDIA

ENTRY FORM

COMPETITION:

DATE OF COMPETITION: ---~~:_~5-('.pri~-~~~~------------------· STATE: ASSAM

-Family Name Shirt First Name

Date of Birth Hockey India No. [PRINTED- BLOCK [PRINT~D - BLOCK Father's Name (ddlmm/yyyy) ID Card No. 1-32 LETTERS] LETTERS _u_ SINGH PRITAM /6056 NAUENDAR S!NGI-I 13-08-1992

0_~ BORO BALIN l.6 o~:t KAHNABORO 11--11-1997 01296

19 KADIR ABDUL I r-, o~ Si MinJANALI 24-11-1994 -

0~ HAZARIKA MOON I t=.n ca GOPINATH HAZARIKA 16-05-1994

15 SINGH KARAN 16060 BALDEV SINGH 24-08-1994 01792

17 BORDOLOI PLABAN l6o61 BABUL BORDOLOI 31-12-1990

IZ CHETIA DIPANKAR /Go62. JOGESWAR CHi<:TIA 04-10-1992 -

03-06-1?!3. t -----1 /?., SINGH ASHU ltSo6' 3 LT. RAMBAHADUR SINGH

07 ANSARY RATUL(€ol4(~) ABDUR RASI-lll) ANSARY 31-0S-1'194 , I ·-·

09 I BORO RITURAJ I 6 0 65 SURJYABOP.O 04-08-1997 il129S --------.- f-----

0 I II · MAtfESHGOWDA KEERTHI ('j. j,( ) M. MIH-L.fS~-~wotl 19-12-1990 ~Go(.c, ----c.-:-06 SWAMY. 6 NAGALINGA /606 =t SoMIISH~ I(.ARAPP1J . 15-08-l ;9 il

-1_6 KHAN SALMAN I bOb \A WASHIKHAN 21-09-1996 C!793

r -- ···-

OR HUSAIN SHAHIQ . I nOb 0, SA YYED AHMED 25-12-1993 01'191 . --f-.=------t-

r-f4-- KANAUJIYA SANDEEP 16__o::\O. SURESH KANAu.JIY A 01-11-1993; '

HUSSAIN I ABU~~ ':\·I ABDUR RAHMAN 31-12-19981 1)0832 ·--

02.. KATKEM . RAHUL 6o j2- MONOHAH(KATKE 30-12-1992

31 YADAV :1 ~ [14BIR f<AV ~ :\ KANA YLAL KANBHAILAL 31-05-1994 'l . \bO . j U'f -/ 4~) YADAV

TEAM MANAGER: C11Al'<lJANMAHANTA~g-'ttJt88:?8S rCOACH: AMITAilH GAUTAM -'JO 2t t, 2 8'335 -~ r I hO_±Sl_ _ (: 1 0 f:~ J

Shirt: Yellow & Green

Shorts: Black

Socks: Green

TEAM COLOURS

Goalkeeper sh!rt: Y~l.Lou l t;R'Eol'/. (Must compris~ different colour to both primary and alternate colour of shirt)

ALTERNATIVE COLOURS

Shirt: Blue ($K.y SLOE)

Shorts: Blue , .

Socks: Blue "

Goalkeeper shirl:

.,

" (Must comprise different colour to both primary and alternate colour of shirt)

One set must comprise at least 80% single colour per piece. Goi?!keeper shirt must comprise different colol:r to both rimary and alternate colour of shirt. --------------

Name: TAP AN KR. DAS Date: 02-04-20'15

Position: HONY. SECRETARY, ASSAM HOCKEY Signature :

Note: It is mandatory for the participating team to be in-pr_o_p.::er kit with correct shirt numbers a'ld colors, failing which they will be penalized. Also, it is mandatory for a teain to bring two s"ts of Socks (to avoid any color clash).

"1

0~ \\OC-t~

::; '~ ~ ~l \~ )if/ \~ "-{f.J7 '-.:Pilo\\i.~ ____ _....

HOCKEY INDIA

r6o f-3

COMPETITION: 5th Hockey India Senior Men National Championship 2015 (Div B)

DATE OF COMPETITION· 06 15 Mav 2015 STATE· UTTARAKHAND

PLAYERS

Shirt Family Name First Name Date of Birth Hockey India ID Card No. [PRINTED- BLOCK [PRINTED- BLOCK Father's Name

1 32 LETTEF<SI LETTERS (ddlmmlyyyy) No.

.:?1 kt>""r.tl .("(..,.;) AlhT""r7 I' . f'>l\ "'"'"" ol.{ I a"'' II"> n,., 160 ':.) . h

O:J ...... M "I· h. :Tn"'-""'r -~-~11 ... 11~"-~ lboA-:,_ ··· 1'"'' -"1"~1' o:5 u: .. ., '"'"' (c._) ,....~"' lrll..,,..., . T:<.S. LATio1D.I 1.::1 lc,.;l\o.,O,n

o4 -1" Til! A Q. ~.N. _C::. :::J:T AI £J. 1::/ ,_,<;1.--;; i6o~ os- .0~/IJT ftAJk'.rr I i2+JJ23".5,.; PAAI/ I""- looii"'"'C I A 0 V'll'l oE, 5-,fl(..,.,.l'\!2 /". ·"''" • .0. P.J\L.4-IA"lo1 l AI o><.los:! 1"'1~ ,_ ino ?.>! ro"7 111.£)/ 7- ro ,..,_, nn"'- '<kz:lvJAO lc S.AJ.au--· ·- • Ito' 0~ I"' "o c;- - ., hO Y\1).. oR .,~

4.TT7' D-S..A •/ - o.:Z bs)l~':l4 ·, (;o~3 c"' '" ~.?£(.} nA n •. s. ·~~N /c;"/d7 '16034-to .,. -~' IYln ..... ·r.-. n.C>/-·'-'' r 1"7 ro ~~flo i"'"'"'- 16oRs 1\

I

M: c:: " f") ""' .~A .::J.Z:.·In; I \"'"'>" 16oRC

1:2 0&:\\.() "'., 'TA'- r-;.,_ !"t O.<ll ML,.., ~ ~(<;;,:';)C I t, tJ '1l ::; 14 .DAII.l..,.. \ ' ll'l1l. .. lt1-HAP I AI .!')~ ,, ""i, ... ... C" t. o~ I tJ }~ l,is IS" 'T n.s .1--1 r " <;A-r~.~':- --~ I_"?< loB I·, <:')"'R /6Cl !lJC, l'7 .PLJJ II_ r. TA'-1 7".J:7"1 7 PAl It> II II~~ 1 Go CJo I~ --,r r>I">A ' .:<?lo~ I J~R"z l(:,oOf! 1...9 KA•"·'OJ I~<~ A. f;;'. v". ". •-"'' ~ .lo"?i 1">84 .l.6_oq '~~

.:<1 S:tAJG-J H (&J.I(\ '-\A<:.OAI SOH~.· 3olo'"7 i ~~~ 16oC, ~ ' Team Manager: fllk', '-4. C·Th">...,'r 941.:Zo896Z9 Coach: f'IIR. B. P. A&IA-RWAl ~S~'8/4o690 --

'lboa c,) '711-0i.fA-) TEAM COLOU~S ' ALTERNATIVE COLOURS

Shirt: BLQE.~ Shirt:

Shorts: BL\1-E Shorts:

Socks: R_o~l'tl... BUJ& Socks:

Goalkeeper shirt: , Goalkeeper shirt: (Must comprise different colour to both primary and alternate (Must comprise different colour to both priinary and alternate colour colour of shirt) oi shirt)

One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both I orimary and alternate colour of shirt.

Name: Date:

R.\'vu-~~ Position: Signature:

.. .. Note. It IS mandatory for the part1crpating team to be m proper kat w1th correct sh1rt numbers and colors, fallmg w:uch they will be penalized. Also, it is mandatory for a team to bring two seis of Socks (to avoid any color clash).

0~ I~ ,,

'0~ OY O}...

0~

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og,

13 l't

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tl .;!.\ 0\ o6

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;-10CKEY !NDIA

5th Hcc\;_ . ., waia Senior Men National Champions! ,p ~:i.J"i !5 (Di'J 8)

:OT!TlOt~: JlE)_f\pril :- 20j-\pri1_;!()15 _ STATE: _:::J_Il(\<._ ........... . ----------- ------------,

PLAYERS

'l Name "LOCK LETTERS

r:,r-::; [PF?INT::.:·:) ~ u I Dar(;

Father's (dc!!i·i

' --~·:n'!pthi~ ~~t ~~ast uc•;:, ·:.:k:·_: ..

· --~:~~~r ~:~ _::.~!ir~~------- _______ _

Name

PAt. SrtrC.\1 'O~~~H IS !~>6

.s. 1 "' c.. '11 ~~~~~ o ~:.It:~-

k.UY'Yl Ail. S~Htm, !:;,~ otjf'-1 lNC,\j_· f'i~ .. ~~sll i')l 1_6_

~o'lfU\ SliAW! LA ~-L~L -'""'A-R>Yl--A \t:.L ~ \lftf!~ IQ. [ o ------

01'¥1 Pil.r.1cr.s, :iih. wl2~\RA

i Gosh·~cz~.:;r sl1ilt . \ (Must corn prise. :ii~7:J:\..;:·:~ C(J:·c- .. .-.... ;..:··.', ·-!; ::;.:x; -~~·~,:i ;.;i~r.:;rn.::.Hs colour of i ohirt) · i ·

; ·- .:::- ;::·.:.:i· ~,:.li;;~l::. G:;:;&lk~!ep.c/r ~;J;rt ;:'!' •. c.-:.:· (;t.:.:·:i- _:t, '.:·,-.; :::,:-,·.;;:td·-,, <.I:::·;;· '~0 L:;)!/1 prii11J.-,.:i j

. ···············-·- ····------·· ····-·-·--···------.--------·--·--! /

I

HOCKEY INDIA

ENTRY FORM

COMPETITION: 5th Hockey !!.l\!l!!!.§!~!li9!.~en National Chall!J?.[9_!lShip 2015 (Dii!.!J} ________ _

DATE OF COMPETITION· 06 April- 20 April 2015 STATE: RAJASTHAN - - ·-·· -·-····-

' PLAYERS

i Shirt Family Name First Name Date of Birth Hockey India ID Card

I No. (PRINTED- BLOCK (PRINTED. BLOCK Father's Name

(dd!m'J'WW No. 1-32 LETTERS] LETTERS

"- 23/02/1993 /£:'2./ "+ 7 RAWAT. DEVAN SHU DEVSINGH '

J'-t KUMAR VISHESH VISHAN CHAND 10/03/1992 I I 6 2- J 3

4 MEENA GAURAV N.L MEENA 16/07/1992 IE> 'l..ICI I __ C6__ KUMAR RAHUL RAMNIWAS 07/0411989 u;2-2-o

~-' -·-.

24 SINGH RAJVEER &1'1-<. BALTEJ SINGH 12109/1991 . /62.21 5 SINGH ~ 19UR~EET (_C. ) SURJEET SINGH 20/0211986 I 1 f. 'l-2 2

L

I 17 NARUKA PRADEEP SINGH KHEMSINGH 17/11/1992 tt:.'J-.2-~ ! }J KUMAWAT SANJAY KAILASH CHAND 17/05/1994 /67-2..4

3 NARUKA PRADEEP KAMAL SINGH 08/05/1991 /6Z..2 c:::. }')_ YADAV SANDEEP PREM PRAKASH 01103/1995 1 1 r-. 2 2.-6'

_)Q KHAN SANJAY KHALIQ 08/11/1991 tf-.'2-'2'1 15 SA IN SURESH AANA RAM SAIN 25/06/1993 J 6 2.. '2.( .

b GUPTA VIJAYKUMAR GOPALGUPTA 1011111993 t-.1 'l.:f . i )-:-{ RATHOR NAVNEET SINGH NIRBHAY SINGH 29/09/1995 6'2.60

9 BAGDI PURSHOTAM GOPALSAIN 23/0311989 62.'2.1 ' /b KHAN MOHO. JAVED LIYAKAT ALl 12108/1985 16 2<~2

I KUMAR VIKAS &,.J.J.. ! PRADEEP SHARMA 15/12/1996 lb 23.1 _2. · SINGH ______ L_ ___ SAN DEEP MADAN SINGH 05/06/1992 /6 ::?-34-

i Team Manager: AYUB KHAN Coach: RENJYSMITH ' q'4J'1t>44474 ( lh'l.3b) "'14r0&SS/6 . .::l { lh"L.:.t.,S.J

I TEAM COloURS ALTERNATIVE COLOURS

I Shirt: ORENGE & BLACK Shirt: ROSE&WHITE

1 Shorts: ORENGE & BLACK Shorts: ROSE&WHITE

~ccks· SKY BLUE Socks: BLEW

, Goalkeeper shirt: Goalkeeper shirt: ! (Must comprise different colour to both primary and alternate (Must comprise different colour to both primary and alternate colour : colour of shirt) of shirt)

' One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both p_r_ll!l~XY.. and alternate colour of shirt.

;

20/03/2015 ~~--! Name: ARUN SARASWAT Date: r

I Position: GENERAL SECRETARY HOCKEY RAJASTHAN . Gen al Secret~ 'Y

S1gnature: u -~ , 0 • •"'" ~ " • - 11

Note: It IS ~andatory_ fOr the participating team oper kit with correct shirt numbers and colo111; falling wnleh they will be penalized. Also, It Is mandatory fj:~~lP-~o sets of Socks (to avoid any color clasht.

Fi:' r· "' -r ~ i; . . GtP.G!! \ '•, I\ x ~_ ..,~-·lt. ;;-: !i

\. ... '--~..'-:}'/" " ~/"" 1 - ·\ ' /'

.J.~,s'~/·

HOCKEY INDIA

ENTRY FORM

COMPETITION:

DATE OF COMPETITION: STATE: HOCKEY GUJARAT

Shirt Family Name No. [PRINTED- BLOCK

1-32 LETTERS]

1 ZALA C1 k:. 2 DAVE 3 TOMAR 4 MARATHA 5 BATHAM

PLAYERS

First Name [PRINTED - BLOCK LETTERS Father's

Name

DHARMENDRASINH /623~ H

AASHISH /6 2 '?> B D NARESH

VIS HAL I 6 2..4--o B

RAHUL G

Date of Birth (ddlmmlyyyy)

25/03/92

26/09/91

12/03/91

26/10/92

10/09/92


6 BHONSALE 16'l-41 r-~--~~~~~----~~~~------~~~L-~----~--~~~--+-------------

HARDI K I 6 2.. 4-- 2_ c 06/05/92 7 SANDHU 17/10/92 DILBARSINGH /Al4-?,

r-----oc---l--=::-:-=c=---------+-=""C""CCc==~-------l-'.._.._--'-.-""--l-c----~--~~~--+-----------~-8 PATEL CHINTAN 16244- J 28/"10/93

21/06/92 9 THAPA C VIJAY /6lf~ I ----w--rzALA--------=--t-;-;K-:::R-:cU::::S-:-H::-Nc-:A-::Sc-:1 N-;;H-:--'/-=-b?-=--4~(,~+-so:----+--1"'"'0cc/1c-;;O:-;;o/9'""0-+-"""""p;:-L-;o/G"'"U;-;J-;;;/Oc:-16::-:3:-:1-c:/1--o4-

11 VASDEWANI RAVI 1~ '2-l/ .:).·+=T------t---1'""8""'!0""'"1/cc90;o---f---------

12 AHIR PINKAL 03/02/91 PL/GUJ/01626/14 I62-4S R ~~-+~~~~---r.R~O~H~I~T _______ L_I 6~]f9~·~.~~K~-~~~~+--~~1~7~/~0~1~/~9~1;-~~~~~--~~--~--~---

VISHNU ! 6 'i-(.Q--t-:o------t--,2:-::-4/"'0"'7/=-95:---t----------

13 THAKORE 14 THAKORE 15 RATHOD SURESH 1 b ')._( 1 B 03/07/91

16 THAPA KIRAN 22/03/94

17 KAHAR SUM IT )6l-S3 L 21/06/92 PL/GUJ/01630/14

18 SON I (h I( AKS AY • 1 6 ;t_ ~ 4- c 01/01/94

Team Manager: DATIARAM SALUNKE ~\b. , " Coach: I.J.THAPA q A ; \

Shirt:

Shorts:

Socks:

ORANGE I WHITE

BLACK

RED

Goalkeeper shirt: BLUE/ORANGE (Must comprise different colour to both primary and alternate colour of shirt)

Shirt:

Shorts:

Socks:

Goalkeeper shirt:

ALTERNATIVE COLOURS

BLUE

BLACK

BU:IE- 1.":, L I\ C..\<.._

(Must comprise different colour to both primary and alternate colou of shirt)

One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both primary and alternate colour of shirt.

Name: R.V.SHELAR ~ Date: 17/03/2015

Position: HON.SECRETAR\(~(, l" ~ Signature: Note: It is mandatory for the partici~cftejYi~to-=b-e-=i-n -p-ro-p-er"""'k'"'it=-w"-·i"'th_c_o_r-re-ct=-s-=h""'"irt-:-n-um-:-be_r_s -canc-d:;-:-co-'lo_r_s"""', f,-a ·"'r li-ng-w:-hi:-c:-hthey will be penalized. Also, it is ma~'i!~or a team to bring two sets of Socks to avoid any color clash .

HOCKEY INDIA

fNili'l' FORM

COMPElTIKl!l!: S"' Hockey [ndia Senior Men National Championship 2015 (Oiv !!}

DATEOFCOMPEnnON: 06 -15 April 21115 STATE: VIlA. NAGP!!R- MAHA!!ASHlJ!A

' Shirt ! ; No. i 1-32 : ol 1. ' 31 i 2:

PlAYERS

family Name First Name [PRINTED- BLOCK [PRINTED- BLOCK Father's Date qJ Birth Hockey India ID Card

LETTERS] LETTERS} Name {dd/mm/yyyy} No.

SINGH CHANDAN (G.II) JAMUNAPRASAD 15.07.1989 6 '2. 5 :}-MOHAMMED AHFAZ (~-Is) ASHFAQUE 30J2.1992 / & 2--~ ~

ti j SABIR AN/QUE SABIL ' 28.01.1987 6 'l- _$ '1 D Zi __,4-_· -1---- BA~G---1--. TAU51F ··---!-- ILYAS 06.01.19_9_1 -+- IA-!bLO«--_ ___,: 011 7- KHAN AAK1L ZABIULLA 07.05.1993 I h 'l-b I 0 J ~ fl. KALAK On SHRIICANT ICAUSTUBMANI 08.11.1992 6 'l- ¢ ,2..

----~----------~------~-------+-4~~~~~ e> b : ;r. RAHIM ASIEF ARIEF 15.06.1991 I 6 'l b 2 i 11. i ~ KHAN SOHAL AHEMAD 04.09.1997 L 6 '2-6 .;L I~ : Y. MOHAMMED--1------AYII_)IZ ___ -··--+--HANEY - 13.02.1993 TG-'2- 6 I 0 r:; Kl. PATHAN SHABAZ AZIZ 02.04.1995 ' rJ.. 'l. 6 6 l ') i ¥- KHAN SHAKIR SABIR 05.04.1994 • A '2- b ~ C/f , H. SHEIKH SHAJBAZ SK. IMAM 11.03.1989 .f p '). b 8,____--:! off~-$.-.· -+----S-HEIKH IMRAN ----1---/MAM-···--1-02.05.-1-9-85-+- /6 ') 6 ~ '

1 1 ; if. SAINI SIMARPREET s:~:R 14.10.1991 / G '2-1-o l ' 0 ~ ! .yf. KALAKOT/ RAHUL BRUKISHORE 06.12.1996 I 6 'l-- 8--1

13 !'-. ~1.f!'-·-!----KH_AN ___ f----~-1R ____ .... ··- SHABBIR -· 25.05.19~9-+-+ lb_tl~.-----!' \O~~~·-r __ KHAN __ o_RICA_R ___ f-__ B_H_U_SH_A_N ____ r-_RA_M_KR_u_sH_N_A ___ r-~-O_l_.1_99_2_f--1/~6~~~~~~~~-~~ I~ l 18. KHAN AKBAR AKHLAQUE 10.08.1991 /6 2 .!74- !

! Goalke.,_ Shirt: WHITE & BWE i (Must comprise different colour to both primal'}' and alternative ! Colour o'f Shirt} i

Goalkeeper Shirt: WHITE & RED (Must comprise different colour to both primary and alternate ooour of Shirt}

~ One Set must comprise at least 10% single colour per piece. Goalkeeper shirt must comprise dirfietent colour tG bath : ! primary and attemative colO!'! of Shi!f.

i Name: VINOD KUMAR TRIVEDI Date: 23.03.2015

i P<>:<it_ion: HON. SECl1HA~Y _ -·-- ___ ... ---· ~113ture: . il<. ),..,--<.A Note: ~t l5 ~ for the prdctkffig team to be iR ptopet kU with .(X)(.f.et.t shill m.m~ts ~r«.1 c.o:lotS1 fdiUng which lhey w.ut be penali>f<!. Also, it t• mandato'V fora team to Mngtwosets of Sodcs (to avoid ;my colar dash}.

' ?,~.-';?

·--~ ·r~·- ._,, .- -~·1 ';;>-!'

"

IC ?- 1-r t & ~o, s 5"' Hockey India Senior Men's Championship 2015( B Division ) PO'ii'il,"Maharashtra From

5"' April to 15"' April-2015

iiOCKfY IND. A

ENTRY FORM

COMPETITION: 5m Hockey lndiasenior Men's Championship 2015( SO!vision) Pune, Maharashtra

COMPETITION DATES: S"' April to 15'" April-2015 Team Hockey Anbdaman & Nicobar LAYERS

Shirt No. Family Name FitstName Date of Birth Age International 1-32 [PRiNTED- BLOCK LETTERS] [PRJNTED ·BLOCK LETTERS (ddlmmlyyyy) Matches

1 TIRKEY VIJAY 16?.-~+ 10/101981

2 BARJO SULEMAN /G 2.:} g 2/1/1990

3 EKKA AMRIT I$ 2.: !fq 19/4/1981

4 DAYAL RAM I 6 2. .80 111/1972

5 TOP PO ASHWINI I 61-0/ 9/4/1988 6 KUMAR SANTOSH 16'1-~2.-- 9/6/1987

7 TIRKEY BIRENDER /6?..3~ 23/5/1987 '8 GOP &!.·!< SAN DEEP (6Zh4-· 2419/1995

9 MINJ BEJESH KUMAR (623~ 16/5/1992

10 BEHENGRA PRADEEP It,'].$~ 10/2/1994

11 TOPNO MURIS .IG2'ib:f 917/1993

12 KUJUR PREMRANJIT 16 2-1'!!~ 2/1/1985

13 HER ENG ARVIND /6 '2-$9 3/61991

14 MINJ (CAPTAIN) XAVIER /6 7-.9o 26/1/1988

15 .KIN DO A SIT 16 2--q I 12/8/1993

16 TIRKEY (GOAL KEEPER) DHAMAIN 162--CJ 2... 10/5/1977

17 DUNG DUNG PRADEEP I 6 'J..Cf 3 16/2/1983

Team Manager: POLIKAR KUJUR«~ Coach: INJUSH BECK f r>!tf:rj {]~{'J!, Stand-in Manager: ( 1 {, ).q~ Assistant Coach: ( I b 14 Jt-) (Shall not be Coach, Assistant Coach or Team r)

Team Doctor: Physiotherapist

9~~23561.90

TEAM COLOURS ALTERNATIVE COLOURS

Shirt: BLUE Shirt:

Shorts: ORANGE Shorts:

Socks: BLACK Socks:

Goalkeeper shirt: RED Goalkeeper shirt: (Must comprise different colour to both primary and alternate colour of shirt) (Must comprise different colour to both primary and aHemate colour of shirt)

One set must comprise at least 80% single colour per piece Goalkeeper shirt must comprise different colour to both primary and alternate colour of shirt

Name: M.A.MANOHARAN Date:

Position: SECRATARY Signature: -----

HOCKEY INDIA

ENTRY FORM

COMPETITION: _5th _l:i~~-~13_y_!ndia Senior Men National Cham~on_~l!ie _ _?O!§__(Rl~ _ _§) _____________ _

DATE OF COMPETITION: __ _Q§._6p_r:ll_= __ 1_§__t.p_r:)L~Q_1_§ __ _ STATE: HOCKEYPUDUCHERRY

PLAYERS Shirt Family First Name

Date of Birth Hockey India ID Card No. No. Name [PRINTED- BLOCK Fathers Name

1-32 [PRINTED LETTERS (ddlmmlyyyy)

-BLOCK LETTERS I

1 16,~1~ M. VIGNESH G-K. K. MOUNIEN 23-10-1993 PL/PUD/01669/2014 16 lh _q,l'+ S. DAYALAN P. SIVAPERUMAL 13-08-1986 PL/PUD/01671 /2014 3 t.'?..Jf!J G.SURESH K. GOTHANDAPANI 30-03-1984 PL/PUD/01668/2014 13 I 't. 'il ') V. RAMALINGAM VIJENDIRAN 24-09-1995 PL/PUD/01663/2014 5 u:?,. '1-0 R. RAGU R. RAJAGOBAL 14-03-1989 PL/PUD/01664/2014 12 j.)./ J. SUDHARSAN R. JOTHI 27-01-1991 18 b~'l-1- N. KAMALAKANNAN V. NATARAJAN 16-07-1985 PL/PUD/01672/2014 14 .5'2-.'?. V. KARTHIKEYAN S.VENGADESAN 22-11-1988 7 If ~']_. 4- M. HARIKRISHNAN M.MAHALINGAM 17-12-1984 PL/PUD/01676/2014 8 16?.').~ N. SELLAMUTHU S. NADARAJAN 25-11-1987 PL/PUD/01673/2014 10 ~ ~7- (; K. SANTHOSH KUMAR M.KANNAN 12-05-1988 15 I >, '?,~ 1-- A.TAMILARASAN V. ANJAPULI 06-07-1993 PL/PUD/01677/2014 4 . /,3,'2.& R. GUNASEELAN K. RAJENDIRAN 17-01-1994 PL/PUD/01674/2014 9 lh'1,1-l1 M. JAYARAJ c A. MOORTHY 26-08-1986 6 /~ 't 10 S. DAISAN S. SIVASANKAR 13-04-1995 2 16 'l~l K. HARIHARAN N. KISHTAPPAN 07-06-1991

11 /6l>2- K.RAJESH S. KANNAIYAN 08-01-1991

17 I t '3. 3.1 R. RAMESH G-l<.. B.RANGANATHAN 08-01-1989

Team Manager: N. NARANDIRAN (09600994417) Coach: R. SARAVANAN (09894113707)

r tC..?.7.<) r 1 ~ 1 'l.i+) - '-TEAM COLOURS ALTERNATIVE COLOURS

Shirt: Royal Blue with Wight Shirt:

Shorts: Royal Blue with Wight Shorts:

Socks: Green Socks:

Goalkeeper shirt: YELLOW Goalkeeper shirt: RED (Must comprise different colour to both primary and alternate (Must comprise different colour to both primary and alternate colour colour of shirt) of shirt)

One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both primary and alternate colour of shirt. .------

//1. ·t ;• f 1 ~~I ··--..

Name: R. EJILANE .. .; .. · -"'~) <' (• ~

Date: 04-04-2015 ; , . _f·-' , ~ r-~ ... -.. ,. \ • • .·; )>-·I •. /;"I•. ~.

! >··.';~.:.:..:_. ·- -~~:·_J--~/ ..:•\~ \

~~y I_:~- {.,-•'.\ '- •. · '")' I

Signature: Position: HONY. SECRETARY! ,:·_r,:~~::• ~,;I;:'~''(C; \::'. __ ;·/' \. -1 ~- \~:-:.~. ~>~·~>-?-<. ... W! :~ l (

/'F) E H'j "> NW \ (; \i / _, '• ; ·)"' .... )' "J .l ... u .J.,!,.,';:..: < . -;.. ; .... -- /_.- ......... __ :--- '- -....j ::- , .. ---.. 1 <·,-~r-:.--:r::-r,':'"r:-.• .

Note: It is mandatory for the pa 1<;il:(!(ti'l9 tea 'Jb t]o/ln proper kit with correct shirt n · 'ber$-~_riil ~<ioiars~f~ilirig which they will be penalized. Also, it ist'!-.!'c;l~~9rY!f:a:J~im to bring two sets of Socks (tcf~~~~~~y;~~L'?i:'{ijoi.sN>' ·--. ...____:. ___ ..... . -

1 0 ~._:.J_G. __ I b_'3._5_.~ --HOCKEY INDIA

ENTRY FORM COMPETITION: ... ~!!:J .. !:J£9!5.~Y .. Ln_~i~--~~.Q!9E .. I\i1.~!:1-~~!!£!l~Lg_I}!!~.P.L<?.I1_~~-if! _ _?_QJ_§__(!?_!Y.l!L _____ _

DATE OF COMPETITION· __ 06 April- -~0 AP-J"JI2015 STATE· CHHATTISGARH

Shirl No.

1-32

Family Name [PRINTED- BLOCK

LETTERS]

PLAYERS First Name

[PRINTED - BLOCK Father's Name Date of Bitth LETTERS (dcVmfYYyy

Hockey India /D Card No.

~_16 -----1_:::B~E;_HRA~-----l--,-A,.,.KS~H=A~Y_:_A_:_J_A Y_'L (' fir=· 1.:.,;< t-A.,..,J'""A Y=BE77

H.,-:Ro-:A -.-.----f-:1"""1...,..12;:;-. .-.19"'"95.-t---'-"'-lS -'.':3'-:::?,:'--(.;<----i Jl · YADAV MANISH ASHOK YADAV 25.06.1997 1 t, ~3. i

/'-t PAREEK RAVI LT. H.R. PAREEK 18.06.1989 \e, 1,3. <6 ~~ ~0~9-+~PI-LLAY---~~U~P~E~ND~R~A--'(r_G~)~L~T.~A~N~IL.~P~IL~LT<AY~--~2~6~.0;:;-9 . .-.19~91~~\~~~.~~~~C--

J o TIRKEY NAVEEN LAJRUS TIRKEY --l-~08~.0=7~.1=99=5-l--1-"' \(:,""""' ?,, 4-o'-'--0 J CHANDEL VAIBHAV SING~t.;.K M.S.CHANDEL 13.08.1991 1 £,3,4 03 YADAV VISHNU RAJENDRA YADAV 22.11.1994 j C., !h4-l 1 ~ AHMED SHAKIL RAFIQUE AHMED 01.08.1993 1 t-, ':1-,lt-'1., 12. AHMED TAUFIQ RAFIQUEAHMED 02.07.1995 1 t-, '1.44-Ol.f YADAV KHUSHAL P.S.YADAV 14.07.1995 lo3A-S /S RAZA HASAN MOHAMMED HASHMI 15.08.1991 1 (; :14- b j r QURAISHI MOHO. ATIQUE M.Y.QURAISHI 03.06.1989 1 t, ~4'+

02. KALIMI MOHO. MOHSIN LT. M.M.KALIMI 25.08.1994 ft~ 4-?J o8 RAJAK HEMANT ruLsl RAJAK o2.o4.1993 16 !3. +Cf 0-, RAJAK NILESH ISHWAR RAJAK 23.04.1994 (;, 3,_$ 0 15 PATLE SUM:I:T ARUN PATLE 26.11.1996 63! f

~O~b~8~A~A~~~----+~K~HO~G~E~S~H~W~A~R~-+-s~H~A~s=Hr8AA~~-----+~11~.o=9~.1=99~4+--~16~i~,~2--

r· OS • MAHESWAR RAO K.SATYA K. POTHU RAJU 02.07.1985 l (:, 3,~ 3 [-.;:eam ~~nager: DALBEER SINGH .;p -5 j1r~

Shirt:

Shorts:

Socks:

Goalkeeper shirt:

TEAM COLOURS

MAHROON

MAHROON

YELLOW

(Must comprise different colour to both primary and alternate colour of shirt}

Coach: AMITABH MANIKPURI -~

Shirt:

Shorts:

Socks:

Goalkeeper shirt:

ALTERNATIVE COLOURS

NAVY BLUE

NAVY BLUE

SKY BLUE

(Must comprise different colour to both primary and alternate colour otshirt}

One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both prlmarv and alternate colour of shirt.

Name FIROZ ANSARI Date: 06/04/f015

\,':,_ (\.. ~ ... Signature: ~~ Position: GENERAL SECRETARY

Note. It rs mandatory for the participating team to be In proper kit with correct shirt numbers and colors, failing which they will be penalized. Also, It Is mandatory for a team to bring two sets of Socks (to avoid any color clash).

---HOCKEY INDIA

ENTRY FORM COMPETITION:

DATE OF COMPETITION:

PLAYERS

Shirt Family Name First Name Date of Birth Hockey India ID Card No. [PRINTED- [PRINTED - BLOCK Father's Name

1-32 BLOCK LETTERS (ddlmmlyyyy) No.

LETTERS] 31 TAITES INCOLN c._c:; V I t,:?,SP, THOMAS 1 b -IJ,(;'- /'fe:z

l 2 NAIN KULOEEP lf.'2..!ot NANDLAL ID.2-10-/'1?4 12 NAVE EN I A '1 f..f"l BRAHMANAND I 1- /!-19q:;-15 CHAUHAN KULDEEP lA ~~I MOHAN SINGH tl3 -tJI!-1996 .. 14 SINGH ATINDERPAL /6 ~li'2 HARMESH SINGH ()'J-&1 -fqqr, 7 KUMAR PAW AN 16:56?, JAIKARAN \ :J. 4- 0 1-1 'Y9 2-8 NEERAJ I 616-+- SURENDER I /6-03 -l'rr/3 17 SINGH JAI KISHAN I A 2-,G "', JAI PAL SINGH !S-!:Z-Jqq6 10 - VIJAY I A g6'~ SURESH CHAND tJC1-61-!9t? :s 11 KUMAR RAVENDRA It, 3.6 SHIV KUMAR o0 -05-Jcrqs-5 - SACHIN 'I fi 1.6 SAMAR BAHADUR r-1 -{)q -/1']/, 13 SHARMA/. ARVIND I f-. Z.Gq SITARAM SHARMA 'J(Y -62 -19'12.-3 KIRO / AMRIT C o I (, (!, ':Jo STEPHEN KIRO ?-Ct -tJ s-1'1 ';$ /.-9 KUMf'\.R NAVEEN I I. 3 :}-f MAHENDER RAI IJ{f-/CJ-/(q{f

16 D'SOUZA BOON /{-.:3,..}2.. NICHOLAS Zl-07-/'lt/1 4 TABISH MOHMMAD (63.~& FAZAL MOHMMAD 1~- o6·t9 'lit 1 OLLA VI NOD c_ <:15)J 6!!.:}4- ROHTASH 19-0G-/Cf('f

c 06 - NITESH ,/bS~5 PUKHRAJ J/.+0 -:5-J'/97 )

T Team Manager: MANOJLOKHANDE~~ Coach: KARTAR SINGH H-1£ "9/69/I.J n. h"" •(/f::z?_ '7':5].2-61>:,9:5,9 (lb$-11>)

TEAM COLOURS (I b~ '11 > ALTERNATIVE COLOURS

Shirt: Red with Yellow piping Shirt: Yellow with Red piping

Shorts: Red with Yellow piping Shorts: Yellow with red piping

Socks: Red Socks: Yellow

Goalkeeper'shirt: Orange Goalkeeper shirt:' G(een ..

(Must comprise different colour to both primary and alternate (Must comprise different colour to both primary and alternate colour

colour of shirt) ,~f.LI H~ One set must comprise at least 80% single ~prece.~ eeper shirt must comprise different colour to both primary and alternate colour of shirt. . :~.··' -"; ").

u f l, );'~~

t~·JL4 Name: G.Raji Reddy :z , , , ; : t-U\ 'Da "' """l " .. Position: Han. Secretary ~ ~nature

~-- ..... "'o * .. Note: It is mandatory for the participating team to u~ "' f'•Oper kit with correct shirt numbers and colors, failing which they will be penalized. Also, it is mandatory for a team to bring two sets of Socks (to avoid any color clash).

HOCKEY INDIA

ENTRY FORM COMPETITION: 5th Hockey India Senior Men National ChampionshiP 2015 (Div B)

DATE OF COMPETITION· . 06 April- 20 April2015 STATE· . BENGAL

PLAYERS Shirt Family Name First Name

Date of Birth Hockey India ID Gard No. {PRINTED- BLOCK {PRINTED- BLOCK LETTERS Father's

1-32 LETTERS] Name {ddhnmlyyyy) No.

0~ .LA~A lt3_';tj_ AKHlL C'.ITPfAI'I'D f', 0. l..cd!.., D4•12•tj\3 0~ SAHA It, '3~C, AY~ ~GI· I()_ P.k.~ ''-·1'2·q"l 21 SJNGH lbl?IO R'AHUL KIJM_l\1'<' ( ~, k.) A·~~ .ol·cJl1·qr 03 MA tRYA \6'l% I SHmCMANI KUMAR I A- 1\o.• ~ 2o, o7, ~ 4

11.-( YADAV I 6?.. ~2. RAM VrJAY B·l>Yohv' 15'• Ol• q I OV{ PAL I~ 1%1 SANDEEP A-· Pa.! '-0• I :l • 'l 'I

12.- SHA~ \~~'!A- PANKAJ J', .S.h.ll=. ~·04·~ CJ6 BHUIYA I{,\'% 5 SHUVANKAR' ~·BWV<,. 2.(,• 12 • <JO

os· SJNGHI(,1,?£, R'AHUL '[).~ CJ2. 02. ·ll ~~ ol KHAN I()~Q,!:} MOHD. SHoEB

M. I""·"- DI•Ol•g'3 of] ROU'IH I b'llb <6 AKASH ,S.f?ovt;l., ,g,o'9•lll 0 q R'AKSH IT I b!:. 'b ~ SUPRAJIT ~ .Rn~<>~u;.r :21•\0olj(

{0 SUmAS \b'?:80 SlRAJ KtMAR N<~""'~ ?.3· 0"\ • 'l '3 I I SAHA \ fo '1~ I ATANU 5·Woa. z?.. crt• '1 >"' I) RAM I b~Cf 'l- Vn<KY KUMAR fl>·~ '-4• 0~ ,Cj 4 r.{, CHATTERJEE AYAN lb~Of3 ~." .~ 27•1Jb·% t( BARLA I b l Oj 4 ROHIT L.Bcvrt... dH>~· CJl IS SJNGH W1CfS PRAMOD KtMAR ~.~.~ 14 • D.l.'\ @-f,

T earn Manager: AN ISH KtMAR GHOSH , Coach: Po·KoJEENA (Cf9SO S'~S'q12), L'115~U~!:>-0Ll-"1~) (I ~'f~} ( 16~'f6)

v


Shirt: 3t,Uf: Shirt J...JHlTE ,..., Shorts: 8L..Vt: Shorts: 8 L.ue. Socks: BkVE' Socks: e,Lv c

G ~~ Goalkeeper shirt: R t: t: N Goalkeeper shirt "i E: f.. t W' (Must comprise different colour to both primary and (Must comprise different colour to both primary and alternate colour alternate colour of shirt) of shirt)

One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different G'l!_our to both primary and alternate colour of shirt · · ·

SWAPAN liCJfJKXR BANNERJEE . ~ ~~ Name: Date: 2. 4.15 ~ ~0:

HONY. CRE't' . .<:\\1 Position: HONORARYNSECRETARY Signature: c'r~NGAL HOCitEY A~c· .. ,-Note. It Is mandatory for the participating team to be In proper kit With correct short numbers and colors, falling which they will be penalized. Also, It Is mandatory for a team to bring two sets of Socks (to avoid any color clash).

HOCKEY INDIA


DATE OF COMPETITION: ___ Q§ __ ~p_ril_=---~g __ ~p_rii_?Q_1_(5 ___ _ STATE: CRPF

PLAYERS ' Shirt Family Name First Name

Date of Birth Hockey India ID No. {PRINTED- [PRINTED- Father's Name 1-32 BLOCK BLOCK LETTERS (ddlmmlyyyy) Card No.

LETTERS] 01 GURUNG DHARMENDER) f<!-T K.B. GURUNG 16 ~q 16 17/05/1976 01643

16 CHOUDHARY ARPIT q-1<_ RAMSHARAN CHOUD~ARY ~~ ?Git~15/05/1992 02 XAXA NEMHAS L T SULEMAN XAXA II, 4-~ o' 10/05/1979 01657

04 EKKA SAROJ LT. MAKARIUS EKKA 1 b4 0\ 10/01/1994

29 KUMAR PARDEEP SURAJPAL SINGH I o.t\-O 'l- 07/07/1985

24 KUMAR NARENDER MALKHAN SINGH I ~ 4-0!!, 18/05/1992

05 EKKA KULDEEP L T MARCEL EKKA I f, t}-o 4- 19/08/1993

12 SAINI PARBHAT(C) LTVIJAYSAGAR SAINitf.,lr-0~ 13/07/1977 o/6_\~ 06 MINZ ARUN LT. PREMANUS MINZ I ~A-t;>G 08/06/1994

03 KUJUR RABINDRA MANI KUJUR I b 4-o !!- 10/05/1993

15 KUJUR BIKASH RAPHAEL KUJUR ~~+t>lb 20/02/1994

10 BAR LA MIKHAL CHOHNAS BARLA ll -t-v 0, 14/07/1992

22 TOP PO IGNACIUS THADEUS TOPPO .t4-lo 10/01/1992

18 SINGH HARMINDER KEHAR SINGH G4-ll 16/05/1992

17 TIRKEY JAY ANT LT. ALBINUS TIRKEYI G41 'l. 12/06/1992

14 SINGH GURJIT SUKHBIR SINGH I tAl~ 08/05/1993

09 DAHIYA BALRAM RANDHIR DAHIYA I ~~14- 24/10/1991

13 SINGH RAJINDER JOGA SINGH I 641 '5 16/03/1982 01650 \

-;;;=Vl,_' / T earn Manager: JASWINDER SINGH C::X Coach: MUKESH KUMAR

TEAM COLOURS (I b+J 1-) ALTERNATIVE COLOURS ( I 6"fl{.) Shirt: RED

Shorts: BLACK

Socks: BLACK

Goalkeeper shirt: GREEN

Shirt: YELLOW

Shorts: BLACK

Socks: BLACK

Goalkeeper shirt: GREEN

..

(Must comprise different colour to both primary and alternate colour of shirt)


One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both. prima and alternate colour of shirt.

Name: Date:

Position: Signature: Note: It is mandatory for the participating team to be in proper kit with correct shirt numbers and colors, failing which they will be penalized. Also, it is mandatory for a team to bring two sets of Socks (to avoid any color clash).

HOCKEY INDIA

ENTRY FORM COMPETITION: 5th Hockey India Senior Men National Championship 2015 (Div B)

DATE OF COMPETITION: 06 April - 20 April 2015 STATE: 131#/ltR

PLAYERS

Shirt Family Name First Name Date of Birth Hockey India ID Card No. [PRINTED- BLOCK [PRINTED -BLOCK LETTERS Father's

1-32 LETTERS] Name (ddlmm!yyyy} No.

32 "'.tl M £CJ>WL. /<UN/?ff{((ryJ<J.C .5: .V'tJII7§ffiJ o!> -J "- /9-""- 164-l't O'J tzf;:_i!S.EN .T ..S#l//.SH /. .1-J ERff>V.7 IJI!-o7-/5'.9!i' 164-1 17 B!7E/VG.f?l? 3/C::.So 7..fS8.E/Yt::A Jo-o/z-1989 in4W 07 7"Jt;r;;tP N/tRtflJ' ,v, /d- o6 _/ 9,f>4 '~ 4-~ O{ />-f/NZ 2'0/i/ / -r l.-#1/VZ IJI-o9 /39,.2 iG A:i-2-0]' )IE/KE/V.J S/?N..J/ly T.HERflAI!J" ;3-09-/99.2 ' (., t\-'J.. :?:. /0 LJ'JKJ<.I? 1--J/.L..so/l/ [A. L/fkR/1 /.:?-o!?-/98& \bl\2.4-os-· //tJI.k"EY J";:?N .;:T II? y kr· 7'/tJ/k,£)" R". -//-/;?6'.2 \6A2.-C II ':BII?IAL/1 ~Dhi/V IL.31i!RM /o-.IP-1997 lf..t\2.b 19 N/A./2.. . JVI?V£/ON f'. t';f IN 2: o7-J/-/997 lb~14-

o;L .kCE-o/;frfi. !5h'/P7 b; ('. f'~#l£/li D.5'- o3- / 0"8 6 \.I '2- 'b £0 /<C/1'7/?IZ .Sifl/>:7.3.-«v IN: o /o -/.;? _J;J-9 9 bt\-l-11 ot; (/U1N!? .,£_17 /1-.SH J /<1//'7 ,q R IN.@- RflkJl o7-0J- J9V I 6.A..~O IS NuJV / JV.2)ff?l? L • PtR!lSil:; 125-oS -l.9-P 3 6 4:?, I I LJ k/l,s'h'YP?P /.W?NJ..S/7 ku.N/?iR P.L-kft~.b""' o6-o:?-/995 lb A-~l-o8 'fi!f!JZ./1 N2l· l'?t!lN/tR ;<Q).H./lL7 /0-0/-_199.1. 64~1 f.i £.klr::A :::f<:;tR/cf.S.,?J (ROSPAJ/1/ ::J,E/<kJ? lu- "9-J 9' 92 b 1\-3. 4-16 .SIIN/12) -='.h'/..Sh'JIR ( 6-, A:. ) -r;J/?1711» .29-l/l-/9R9 I 6_!_~~

Team Manager: :R. i'J t'H<o- I Jt< 'Z/'/.ZS ~a: ·· '983)'0/371· oach: 7( ,4 .23 23 z ~ o.._<.;;.ij A' .-Y fMo-8y<J5/~ /$.."!8 -, r '€4~>r) '"'-- l u;, U.l...b)


Shirt: YEt. L. NJ -;. 'J?E2J c.s 7TR.! r?..J Shirt: R£2J + YE.LLOhJ {.> 7111.; p.,)

Shorts: Y EC..L.o£.,/ >'- ::<?,£7> [...s7CV!i'.J Shorts: :RE2J -r y £L.Loh! (,.ST::R/17..-J

Socks: Y£LLoJJ + :RE:D (..S;T(i?J!l'.J Socks: :REJ> + Y.&uo/..J (,.c:r?JPJ

Goalkeeper shirt: N??.KOON / .BL/?C/( ·Goalkeeper shirt: • .BL/fc/<. ) G IREc/v (Must comprise different colour to both primary and alternate (Must comprise different colour to both primary and alternate colour colour of shirt) of shirt)


Name: M.2J,,/yU-S#ThJ!S)Oe A7#-o/h'..2) Date: 0 "'- o.-3- /2tJ..LS

Position: GENE:l?/lL ~EC9?.ET.RfA.y S~gnature: ~--.. .. Note. It 1s mandatory for the part1c1patmg team to be m proper k1l w1th correct shn1 numbers and colors, fa•hng wh1ch they will be penalized. Also, it is mandatory for a team to bring two sets of Socks (to avoid any color clash).

HOCKEY INOlA

ENTRY FORM

COMPETITION:. _ 5th Hockey India Senior Men Na~on2lfhamjllilnship __ ~Q_15 (Di~---------·

DATE OF COMPETITION: _ 06 April- 20 Ap[il 2015 STATE: ldJ:>..c.l-< w . p M .. : ___ :_ .

IIVI/~DHYA PRAn 'I I . PLAYERS Shift . Family Name First Name

Date of Bilth Hockey ln<!ia ID Card · No. [PRINTED- BLOCK [PRINTED- BLOCK LETTERS Father's (ddlmmtyyyy) No. 1-32 LETTERS} Name

I I<HI-t N TM ~ANfc1 GK. ,,, /191~ i64-3GJ , · PRAiTAPATI · ~~AC~IN I~~~~ ltlf It• · lbAA-o ~ C YAOAv CE-1 A NDA N tt>iB JQQI.. \C-4-4\

'"' I< DR I V/ ::rAY 2Sitz l'itfJ le.441-

'i 'PAsARIA · P~A.vei!N tqf7fltU7 I~A4'~ 6 GDTEL R 1-l N.:t J;,,;. r. [q/.?.11'189 b444 7 1 ~A.:TDHA # RtHil T I 0 17/J9q7 lbl\-4-~ R PAL Oe E. fOAk 1?>/~/ICi"l!l IA446

c:, J5/VIES fVJAYA"-lk ..

U.l4/19l?e l b 44 q. /() RAMPI~AVS.SJi /Q/1(.}/199. bll--4?> II YADAV lVI a 1-1 AJ 1.s 1-l {:t/S,}I q ru_ h 4-tr-Cf 12. · Y/-IJ)A v Dr.;vr-.SH u:I&I19CiL : t-, l.\ l -()

1.?. R /.IJ DLI ~ tO lnH A R MB. NDRA ·• '2 II<: #IQCit: I t, 4- .C::

lh I< HAN .

IRIZWtiN :ur/dlq9o I 1-1 + .5. 1-~~ MAL\hvi> 1\JITIN 11..17 II Cf9. \ (:, 4-5 ~ 16 1Ji..tiJkU~ A MIT .. . ') Dl Ill /19 8~ d:l +~+ 17 lvJ I~ I-ll~ A AJ"AY" 12.t:ii.SiL'~ 64~-~ 18 CHtl PRJ I< A PI L G.K

.. 131 S" tq9'~ \ G4 S6

Team Manager: ALW I_N 6(H;: 1-11 L /(.(JNJIIR Coach: P R.Av E. liN Y.A:DAV 011"'.~43'72Jfl,j n 1 IL('),'\ · O'l?. 'TCl1 ( o/.1 ~ r H 1r '=>'6 J

TEAM COLOURSll v: I I , ALTERNATIVE COLOUR'S

Shirt: $ ky 13Lu. ~ Wl..th.. Shirt:

Shorts: I I Shorts:

Socks: ' Sock~:

Goalkeeper shirt: Goalkeeper shirt: {Must comprise different colour to both primary and alternate (Must comprise different colour to bot~ primary and alternate colour colour of shirt) of shirt) .

One set must comprise at least 80% single colOur per pieCe. Goalkeeper shirt must comprise different colour to both prima!l: and alternate colour of shirt ·

Name: Date: 5/l.t/tS Position: Sign9,ture: CluJ. -.. .. -·- -... --.. . . . . Note. lt IS mandatory for the partictpattng team to be m proper krt With correct sh mbers and colors~ fadmg WfHch

· they will be penalized. AfSo, it 1s mandatory for a team to ~ring two sets of Socks o t?Pk. a/5 ~MlJA . General Secretary

Hockey Madhya Pradesh . '

~--~----~------

HOCKEY INDIA

ENTRY FORM COMPETITION: 5th Hockey India Senior Men National Championship 2015_jQiv B) __ _


Shirt No. 1-32

1

2

0 f) -~~"- 3

0 4

5

17

7

8

9

10

11

12

13

J.4MI

[NAIK

'AHMAD PFRRFRIA

, ... ~. -· ,,

,-.- 16 pAS

,,·,

:I MY

c

61" to 15'" April, 2015

First Name [r-r</1~ l_t=_LJ__-'

UOTIL IVEn

1.41;1

... v :T IDI::t A I(" .41:::1-1

ShAYNt:

'P.NI M

,LIIU v h.IIA Y

MUMTAZ FnNARn

n.4t:::.4~::ti\TH

O.M

RA.IA

STATE:

PLAYERS

Fathers Name

W.SHVAI

INA 1URTHY

fl'U'

1~.T JUEL ·

IARnl Jl ~AI AM

"~" '. IANnRA

KAPPALAN.ARAv " "

IM.N HL

1~.T ,: RABI

MAJOR PORT SPORT CONTROL BOARD [MPSCB)

Date of Bihh Hockey India !D Card {ddlmmlyyyy) No.

U//U0/1~/0

1,,,,_, ·~'~ uv" v" d/1

21/01/1972

£0~11.<1 19 77

0"-./U .. /1982

15/11/1978

14/'t.::II>J// ,, ·-'TO_

Ub/JU/1970 lG l-~ 2.. o6t2t1971 1 6 '1--'J :_<,

29/12/1975 1~4~4-

trea~· Manager: RAJENDRA KAlLAS RAMI>Ith~- Q- -Coa~h: AMJN ABDUL SHAIKH ~ n 1

~hilt: ~harts: ~ocks:

'1 )b/?5) s s Ljl.f( I btl-;}-~) TEAM COLOURS

NAVY BLUE

BLACK

BLACK

Shirt:

Shorts:

Socks:

ALTERNATIVE COLOURS {_ /61./ r ~) SKY BLUE

NAVY BLUE

NAVY BLUE

I shirt: YELLLOW Goalkeeper shirt: GREEN [(Must comprise different colour to both primary and alternate(Must comprise different colour to both primary and alternate colour ol icolour of shirt) . shirt)

bn~ set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both primary and 'colour

Name: RAJENDRA KAlLAS RAMGUDE Date:

vo,.v... SENIOR WELFARE OFFICER ,MBPT Signature:

Note: !tis mandatory for the • .";'" 1 te!'m to be in proper kit with they will be penalized. Also, tt is mandatory for a team to bring two sets of

.

' ~ ~


DATE OF COMPETITION: ___ Q§ __ f.[>_ri!_=---~() __ f.[>_ril_?()_1!) __ _ STATE: 1\11_~_t-J_I_r:>_t,J_8 ______________________________ _

PLAYERS

Shirl Family Name First Name Date of Birlh Hockey India ID Card No. [PRINTED - BLOCK [PRINTED- BLOCK LETTERS Father's

1-32 LETTERS] Name {dd!mmlyyyy) No.

I . PHAI~E:MISAM 61SI-IAM (9/KI P!-1.1-1 ·S I 0 I O'Z/199?> /64-:fg 2. K I-IAN /Oti::M. ISPdiA. DHANAIIIvOY ·•t 7 K!-I·I<·S 07/or/ro9R 164';}-~ 3. i<.SH'aTII!.I MA'{IJM \V\A~\UN ~ KSI-\.1\1\.s '2-Lf/ II kl9'-f tA4-~o .t,. J.... \Ofi(~tv;t\i MEITE.I 1-.. M. M 0'3/oe./t991f I 6 4-~ I . 5. T+J. Ch.l IT StNGI-1 TH.ClJ·S CJS /Olf/1996 I 6 A- <b~ 6. M- .SHITANANbA Q..)M.T-5 01/0I/1992. I G 4--~ ~ -=r (VI. RCJ~~NK.UMA~ SIN& M-~-s (!)I /0~/1986 I f14--IIA-B l\11. PI'<:.EMCHA.ND $tN4H M.'T.S. 02-/01 /t990 164-?.J.S: q IH. I'OAI'lTI S, IN I?) I-I (e \ TH.s.s 01/06/1986 164llh ll'l TI-l. Hl::M<JIT 511\1<='14 Ttl.$.~ ;:?8/0t,/1990 16+c16 (1. L. ; ~E.l:o!.AMANI .S.!N~!-1 .L.. ~.S 05/0S/1,93 ,'((,412_~

12.. 1'1\. AMA~<.lt"T s llll lfll-t 11.{-J ... S 07-/t0/1995 · !G-Li="BI6 14 .P{. AeUNG StNGjH· N-P.S 19/09/1991 ~4-<f.JO, 1§". .L. !Ji --:htxt ----;s, J...GE.JClHN SIN~t.-1 L...t\1.5\ • ,g-;.,,_,,992 lA 4-Cf~

~ TI-l. TillJJ:. A f\.111... · -.: .StNGtl..f Tf.I.A • .s OMO?>/t~9S 'lt;t q I '-A. --.L <J OTIN S I "'c.!t l-1 A· 0 ·S I 0 /06/t992 16t +-q '2. •

~/3 M, \f7 rrn~ .SAN~O'f'MANf ~11\11!7\..1 1\..i.Ls: 2.1/!2-/!~9!:5' ~ 4-Cf ~ ..

J15 /l·~.:;;o.. ~ o S-It f\ t\:1 \.-<_\''IV\ "I\ R w.oz,.s ol h "'\ \C083 6¥{4-Team Manager: ~SH. leOPtS~AI< StNarH Coach: - & \. -- a.......______

~. e» r~ \ ~ \ ~ !R "-S ~ q, I I A -f.Cf ~} . ' TEAM COLOURS ALTERNATIVE COLOURS

Shirt: St<::y c:?>J..UF- Shirt:

Shorts: 13LACI< Shorts:

Socks: R..'t3. t::> Socks: ~

Goalkeeper shirt: ~V y SLUE Goalkeeper shirt: Reo (Must comprise different colour to both primary and alternate (Must comprise different colour to both primary and alternate coiOL colour of shirt) of shirt)

One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both orimarv and alternate colour of shirt.

Name: MANIPUl~ H-Oc..t<.E.Y Date:

Position: . DLV. -'B. Signature: s.~~· .. . . Note. It 1s mandatory for the parllc1patmg team to be m proper k1t w1th correct sh1rt numbers and colors, fmlmg wh1ch they will be penalized. Also, it is mandatory for a team to bring two sets of Socks (to avoid any co!or clash).

t-l~J· Gen. Secntltry a&anlpur Hockey

lmpllal

HOCKEY INDIA

ENTRY FORM COMPETITION: 5th Hockey lnc!ia Senior Men National Championship 2015 (Div B), PUNE_

DATE OF COMPETITION· 06 April 15 April2015 STATE· DELHI HOCKEY - .

PLAYERS Shirt Family Name Fir_s( Name .

Date of Birth Hockey India ID Card [PRINTED- 1rrmv 1 cu -BLOCK Father's Name 1-32 BLjJ(JK L 1 c L lcK::; (ddlmm!yyw) No.

2 .... ~..:• I f.. 4~ I~ Krishan Kumar 20.12.1993

3 t<UMII I c. .o} c I~ Sohan Pal 22.01.1993

4 CHAUI:. .. ~·" RAVI lt'l q. I ·t? Surendar Chauc'h~ry 20.05.1998

5 ~IT . '11-(;~o Chander v• 'v" 24.10.1995 PUDEU01971/2014

6 ZABIVULLA Rafivulla 1 b 50 1 30.03.1994

7 n4141 SA i'ENOER 16 .{ O"l • Omprakas Dalal 12.04.1991

8 RAVI 6 <::o .:s Sure• >ucc Singh 02.09.1995

9 RAUTELA EMON 1~{04- Gopal Singh 0 " •+al 15.05.1989 PI lm=uo198112o14

10 RAJBIR 6{o<! Krishan 26.11.1990

11 KliMA!:> SHARVAN (;,(06 Upender ·~· OY< I 15.08.1994

14 ,r Al:'lll\1 IHo~ Faujdar Singh Rawat 11.03.1984 PI In<=l 101 '" U/LU I' -

15 CHAl..HANfbSoB .... , .. ~·.,·~· Gokal Singh Chau""" 22.10.1993

17 MOURYAI(So'1 VIJAYKUMAR Hanu Raj ~.n~,ry~ 04.12.1991

18 ·" ·~"~ It ~m JQ., , (Cpt~k ,.,., "" 1 Singh 01.10.1993 I

19 - ·~ . l:h ~ ,, i Singh 15.07.1993 P• ;nfiJD1974/2014

20 KliM.IIR . ANIL 16! 2 Raja Ram 12.09.1991 . PI IDEU01973/2014

21 KII .. AD ROHIT 16'~ I~ ""j" •ucc Singh 01.09.1994

22 KUMAR ~~~· r~K: ~~~14- Vijender Kumar 28.07.1994

Team Manager: Amil Bakshi - 09811088582 \

Coach: Dinesh Kumar- 09810144734 f 16i.J5) fi(,StbJ


Shirt: BLACK& RED Shirt:

Shorts: BLACK Shorts:

Socks: BLACK & WHITE Socks:

Goalkeeper shirt: BLUE Goalkeeper shirt: (Must comprise different colour to both primary and alternate (Must comprise different colour to both primary and alternate colour colour of shirt) of shirt)

One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both 'and ' colour of'

~ '"'0>-- .~. Name: Mahesh Dayal ~ Date: 01.04.201For ElELHI HOvr: -"· ·· _ .

Position: General Secretary l'A\ *· Signature: 1J:/~. Note: It is mandatory for the~ ·z:' to be in proper kit with~· I shirt 1 which they will be penalized. Also, a team to bring two sets of Socks (to

HOCKEY INDIA

I G 5 I ~ - I ~53 "-ENTRY FORM

COMPETITION: ---~1tl __ lj_Q~!s.<lY .. !Il.<Ji§ __ §<l_lli()_r __ lv)_e;ll __ r-.l§_li()_r:l§_l_<:;b_<l_rT1P.~Q_n_~b_ie __ ~Q_1_!5_JQilf __ E32 _____________________ _ DATE OF COMPETITION:

<:> __ Q§__,l\p_ril__-:: ___ !!5._,1\p_~I_-~Q_!!)___ STATE: <:::: ___ l ___ <;._ ___ t_ 'S) 2':_ L ht ---------- ----------- ----·

PLAYERS Shirt Family Name First Name No. [PRINTED- BLOCK [PRINTED- BLOCK LETTERS Father's

Date of Birth Hockey India ID Card

1-32 LETTERS] Name (dd!mm!yyyy) No.

.?Z_ ~ ('_ .,0\0 \1 I= f: Q 11>~\-\ A. 0 U\1. I'" 1,-)l{,k. 2...g -I 2..·-C\ 2... ~ ~l':t-01 1<:::..\J"Ti\'r\. r~ "'"' .._ "-'"'- rr.,.fL, ~lh-I~St\ \':1-lc- B::r lA! I~ o6 <;; t"N c.,.,~-\ !V,A:roQ

'-- I\, ~I,Ninl 1+-l...f-'lli '(;!.1'1 ,.,.., s; I• 1-J \.._n \-\ \-H\ () 1' \).. \; \'-\ I p. y: IJ/Ihi. ::1<::<,1- 0"1 16~).0

nO.. 0..\-\ o. ll '\\ h \A -r f',. A C' A t-1 T ~~- lh n.v n • R -1 'L· a' 16~2./ I~ Q,t$\L-n lL'AQ. o...~,-, A RA 'T S ·ll.hM'til~ . 1~>·\1•8o i 6.!'1- ').. ~t.: ~ \-d~ ~ IV\ A \; AR\ '5.t\ , s. P-~1-1~· \"1.-<=>q.,,\1 16~'l-'?. r-.c- ~ \-d~ '()_ "" &> '\-.1 \ "'( ~ N. .... Q .,.., ')..1-Q\-qo I h ~ 2-4· g)_<- '-~"-' I.""H J<, ~ P. 't-1 .T"t \ \< • .:r ~ ;"'" 0(,-Ql.-&q ~~~2.-(

I I C'\-114\-+1".00 ~""'' R·G\111"'' ') \..1 - 1\ . 88 1~!26 b~ L AIV\.A <:?n-~"1-\ I< • P. . )._ 1-\J\l \O·q-q 0 16~l ~ \~ t~~ A~ l M A~ \...lA~ \V) .\. l. ? AI ... ''-''-"~ !t.0-'0 lo ~ \<:.. 'K A C.. '-I aiL ( (' '\ }:, fk¥fl \..\·- ')..• B<> 1~0-'1 o<9 1\AVHDA "" A 1-H" (2__ A S, • fVI Utlt~ 1 6-8- 8o 1H3o \'\ 1 Cl.vflA I""' 'fl~ ~A L ~-\..A Kll \ b-'3-&l '6~31

0<\ \..1 A~~v \-..1 ~ c: RA .J A<N,\IAf:l '{. \- D ~- q I ~~ S'32 ,..., 1l.... A 1" A- \<::. t-..1 ·,c..\< '<i..\.1 ' lr.,. R.A Tille lf--l~·il! IG!3.?. t I C. \-\ 1::1<.. .,__ L <; ~ c. \-.\ \.."\ 0.. C\ ~\ f? ._> (}514£3 U-5'-'11 ·1 b ~?4:._

Team Manager: R. p, '%'\ -\.\ $ p ·, \'-\ ~.\\.MtV<oach: "I. pJ::: A \-\ -A\-\~\) { I'll. ~.,\ y .,

( a"' 'I.-<..:-(, r a 1 :\-'=\--::~ 1 ( ~C\)_\'L'Z.2...1'l..b0' - -.... (_ 16536) ALTERNATIVE COLo~Rs' ( /6 53S'_) TEAM COLOURS

Shirt: a R A 1-i t."' ""-.. Shirt:

Shorts: Q, 'L f\ e.x Shorts:

Socks: (\.LA~\~. Socks:

Goalkeeper shirt: Goalkeeper shirt: (Must comprise different colour to both primary and alternate (Must comprise different colour to both primary and alternate colour colour of shirt) of shirt)


Name: Date:

Position: Signature: .. ..

Note: It IS mandatory for the partoc1patmg team to be m proper k1t woth correct short numbers and colors, fa1lmg wh1ch they will be penalized. Also, it is mandatory for a team to bring two sets of Socks (to avoid any color clash).

COMPETITION:

DATE OF COMPETITION·

! ----------·· ----

HOCKEY INDIA

ENTRY FORM HOCKEY INDIA 5TH SENIOR NATIONAL HOCKEY CHAMPIONSHIP 2015 (MEN) "B" OlV-PUNE, MAHARASHTRA ···-··-·········-···---------------------------------------------------------------08-15 APRIL 2015 STATE• HOCKEY HIMACHAL

PLAYERS· r--Shift 1 Family Name First Name

(PRINTED· BLOCK LETTERS Date of Birth (ddlmmlyyyy)

, No ! (PRINTED- BLOCK · .·.!Lc__ LETTERS/.

Father's Name

1iG.K;j SHARMA SAURABii It('(; SH.JANAKRAJDIWEOJ 01/0311985 ·-------j------ l-----...:...:.--f-5'~~1--::c::-=::-::-::~,-:.:--+~~=---~

2 I KUMAR ASHOK f.. ( '( f;l SH. BHAGAT RAM 24/0611963

· 3_--- T. SINGH rr.,..,c.,~~~r <:"':I. ~ HARMINDER '1 t:.,;: 1 . .; sH. JAGJIT SINGH 3010511992 r-~'---~----~~~~~~~~~~~i~~-------~~==~-~ 1 4 NARINDER / oS 4-o SH. RAM LAL 24/03/1992

, 5 KUMAR RAJ AT (., $; 4/ SH. OM PRAKASH 0310411994 f---"----+-------+---_.:_:"'---+'"~H.+---=:::.:::::..:..:.::.=~--+-~=:-::::::----i

J. 6 LOCHAB ROCKY (. ( 4-:).. SH. NARESH LOCHAB 26/10/1993

7 SINGH HARDEEP ~.4.{4-3 SH. HARBANS SINGH 18/11/1992

'·----'8'---t---,Kc-A:CLC:SH ___ -+-----'P.:.~:::R::SH.:.A;:.Ne,T_/LQ_,,5;7:4L+~t--::::c >H .. c-::7 "",.L"='"'= I<AU::S::-H=---+--0_11_07_1_19_93---\

f __ 9 __ -!----,KA:c1-:Ac:R-IA'---+-----.:....M:.OH.:,I.:,T_jjlil (D,c'~~J!.O"S?-t--S-H_. B_HA_GA_r_KA_l_A_RIA----f--.:."::I0;:.7:,:I1,::99:,:5.:_-J f-~1~0_1i ___ oo~G_RA ___ ~-------'V;:.IN.:.0;:.0~~~~6~~~4~6~~S;:.H;:..J:.:O:.:G;:.IN=D:.:E:::R~S;:.IN=G::.H~---+~~29~/0;51719~9.:.4_~ L 11 I NAURVI l (.., ( 1-+ SH. DALBAHAOUR 25102/1992

! 12 j KUMAR NAVEEN h~ ~ 8 SH. KASHMIR! lAL 11112/1996

~.~. _1_134_+ ___ S_I_NG_H ___ -t------'A.::J:.:AY'--\.')Ij "~-"' <::;.:.\-q4-t_S7H_. G-U~R~BA=SH~S-I_N_G_H---..j....-251_1_21_1_99_2 __ --1 VIKAS j i.. C: <.6 SH. JATINOER SINGH 09/0311995

! 15 ) GAGANOEEP i ~ £ ~ 1 SH. RAM KUMAR 23/0111996 f----------j----------j-----..:...:.:..::...;.:.:::....,UI.:<.<OU-t-----------t-------1

_1_B,G K+! -----i-----"' .. '-'II...LI<:::_._,_T<.,_,_fl.'-LM..J.I-'-' 1111>~~""-~.f.~-"$'-"h"-. .J.Rui:I"-'N'-"IL!...... A""-$!..!.1 N,_,6"'-~H'+. -~o_'-1L-=o,z'-".-'-1'::~. 61l qlb..Jr,r.

17 i 'SINGH I KIJLWANT I bS$; SH. HARBHAJAN SINGH 2010611969 .. lB__1 ___ K_U_MA_R----iL-----RA_J_E_EV--~-'-'>".!.:.:=..:j tf-:_:S:-H:-. Y--O=-G::RAJ,.,-:......_..:-_ ___ +-1-61,-08-/-19-,91----{

~--L-----·-L-~~=----~~~---------L---------1 : Team Manager: OHARAM PAL SINGH .y: . /) .... Coach:

_?1_"1..,)8 ~b'2,oS1 t/ '"<....:/

·- -- - ·t\4¥"(.=-A';:o (_M~· ~;L.O)J.L __ O--UR __ S ____________ A_l __ TE_R __ N __ A __ T __ IV __ E_:C __ O __ LO __ U __ R __ S------,1

i Shirt

Shorts:

: Socks:

Goalkeeper shirt: (Must comp;ise different colour to both primary and alternate colour of shirt)

Shirt:

Shorts:

Socks:

Goalkeeper shirt (Must comprise different colour to both primary and alternate colour of shirt)

~One set must comprtso at least 80% single colour per place Goalkeeper shirt must comprise different colour to both primary and alternate colour of shirt

Date:

Position· Signature:

.................. J:IfMiXCF'fAI; .. H~X.,,

HOCKEY INDIA f?;SS (:,- (G57-4


DATE OF COM PETITION: ___ Q§ __ t.p_ri!_::: __ 1_!? __ t.prjl_c?_Q_1_!5_ __ STATE: CJ1_/!t_N_QH!J _ _B __ t __ h_ _______ _

PLAYERS Shirt Family Name First Name No. [PRINTED- BLOCK [PRINTED - BLOCK LETTERS Father's

Date of Birth Hockey India ID Card

1-32 LETTERS] Name (dd!mmlyyyy) No_

1.-1 < '"'' r. )-1 f2 A 'Tr...1 'N I)~ 0 ::il.hlflll•.! .JJ.JJ·XA )6SS6 q ~ JAI r, H ITAIOI"'.QTII 1-IAtAJTJi •C J(' ~ II• 97 )fj~~:t

I 6 <: /IJ\1 0 J1 HAL J.JA !NT ._._,,. u"'O•f o t,- o?-- 9t:J I (;~.! 8 5i (_ I AI (!, U I Ao.hll J? /IV 0 F. ll P A L ( C, ·K) r7AI '1!"£"/•e 9-1- ·nfl -9( ,t,_$!C,

1.2 ~ 11\J l', i-1 H11~."ftl f t:·/1.) :11/ta,ll· ~ .n ~" 1 • 9t:J 1 b ~ £b J (' '"' (',_lA J2AIN_'ir.,r, u

/

'" l'iillll. "},., ~ ll ';1.-- 9 n P- ~6 r

j'{ (/IAtf'.IA #1/ A '1/ I) ;: t: f) ~ .... r; J !J 0, - J.l-:j{!J t. (j 6 'l-13 <_ J A ttl. t.. /',I !JlJt/Ati')/7 /) DA ~,;;( ol-o?~~1 'Alb .1(

1'1 I e ,,..,;· ,., 1-;..I'J.Q,.....LJ.~,oiJ,; r:-r rr 1 l,..uo~eer. fJ< -oJi'- 910 It.~ 64 l!f (',,..,,.,J., f)..,_.., J../ AA..J"r ~AH',/2£l•( !J q_,,_ 97 IH~S

IO I <:, 1\J r, ), I nvFtf)EF:IJ 1(,. ''-'""''. f- !}_ t'"-o;J- .q,.., ,t.,(fJ: r k 1 AI {f, V. II'. z:l I'. A .1\1 lf)p;: i? ~-"~•-li•C t:J9-J1- 9? ,·A .f ~ .r. 6 k'' All'. n I /_ A j.( ~ ,.., Jlilf.f) ,: At <!..LJ '"". ~ _,}o ~1.9-~9 f..!.5 6 $' __ KJ.-tA;.I J<--.!ni-1{) AI"' ~·fS·J<I-If/A o?--J~. ")..J 6.$.~'1 If I C.JNf', n 117AJ ).hND,:P ().,n ,, m .2.2 -o ("- 9" -lf...(rl-tl

1'1 ~JNf", ,_, f~ At'. ""~ • II) & ,:. j) 'r.u.>.M££1· 'Z l~o';l· 9 t, r, (.+I 1.~ I c ,IJ\, 11. ,., A,._, AN j? AJ P E I bwA. .. -,;.c:: o})r 1.1~ q 0 I H:)l .2.1 <;,, N r, n .~ u k h .'1 ££ 7 illvJ...,,e. 5 ~o-1 o• 9] (,~11

Team Manager: r.,.R,"J ,., (INc, }1 ;::;::t I Coach:

Gli'H1q7qf.1 l"ll~:J..---A\

TEAM co2'ouRS ALTERNATIVE COLOURS

Shirt: Of.-"r N~ 6 Shirt:

Shorts: N111'1 f Shorts:

Socks: 01-flNU.fi Socks:



Name: Date:

Position: Signature: - . . -

Note: It IS mandatory for the part1c1patmg team to be m proper k1t w1th correct sh1rt numbers and colors, fa1lmg wh1ch they will be penalized. Also, it is mandatory for a team to bring two sets of Socks (to avoid any color clash).

\

..

HOCKEY INDIA (b5-.:;5 .... I 65'14-

ENTRY FORM ------------------------COMPETITION: __ 5il:!_)-io~_I5_13.Y_L~.d_!_~§en )p_r __ ~I:J_r:!_ N~t)_<l_~~L9h~!"Q.P.!.<?_r:!shi p_ 20 _")_§j_Qi_y__m _____________ _

D!!.T:;: OF COMPETITION: t\gc..\-;,~~-STATE:

PLAYERS

Shirt Family Name First Name Date of Birth Hockey India ID Can No. [PRINTED- BLOCK [PRINTED -BLOCK LETTERS Father's

1-32 LETTERS] Name (ddlmmlyyyy) No.

f--

Cul-v I "-l•\f IL (CiJ·/{j --

Jb>?-{ \6 ~ .. n ~it-->C.,\t \<...u.._OG€'f' ot, -lo-"'!)_

I D\ ----'-- £..1\tll)i:.€ f .£..~ ~0..,\t (~·kJ G.,9-1A>' I \")... -o1- '\t 16$.::}.( C'& f\.J p,"" "'-" 1-"\ f>t-ll_..

~ '--"'-)wl'"' AI- 0\ -1:>--'\t l 6~':} ~

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if..{~l __ ___Ll._ ! 3 "'s ~ ""L- ~;N.c.\~ ~~~].-~1\..l>. :l-8.- ot,- '11..

\\ Cw l'--<:. \--\ "'ll-~ ~.'t.-><, \-\ C~9-0.,., P I\- o <t -'t).. lb~l()'l. -- o'>- (i' 1\l..'-" ·, "o€-jl_ ~~-B Sl± ~M-"-~ \~ -~~ -1:3 u;cg'?.

b(, 1\1--\ IL\1 f' PI L-- c, ~<;)-\ ~ cC./>, \\-\")...·'1S lf_..{g4-

~$_ ~1'\l!..v.:> i o> DG-ll._ L\ ,...c, I\ S.. "'> >J PtM b\ -I I -"\:3 'u, s:: Y! ..c 09_ \1'\ILP>.'"'.::S \-, £:. ; ..... c., 1-\ \-\P,\C-3. it11>fl. \C- \">--"\)_ i6 (~(, t:q M.~>.tl::Si>'~ l)eQ.. \:....'->H.P.-9-

l-1'1"11 \~ -o~-9]. '16('(:4,:.} (.....\'\Pl.~ b

~---~ '-\ /l,l'\l!...i " t>6-ft...£ "'I.- L; ·~ "''-~" ~~>\ ~/-\')...-"10 ~~~ t>'S;" 1'1 .,_,._, :J '"' QS a...__ '-i 1-4 c., '~ t\Mfl"--;reti \4-\0 -'ll 'tf>{"lil~ \'t ~ ''--H"" \ ,_, 1)£1!._ s.; ...... "''"' ~1'>9-\ "'"'(1. \"1-1-,_-S"' I b~qo

'--' ~- _$.."-'"" ~"' ~6-~ .S,.\>-\C,~ l<.v~.., '" D£11 0~ -0'1-"il /_(,! q) \'"1. "",_...,~; .... l)e-JL .s.; I-\ '1 ·~ (!,~l...-.1 ;,..D<(. \..,- 0 ").-"\3 /6.5.Cf?--

l2~am Manager: tv\1>.\...IL\-,- !:..\ ~'11+_\ Coach: \<."'-<\1-ll!.t [\... S:..\>-!>C.I\ (\,.p.;~.,..f\ {lb>,IH) r--·------+'1-Q..&...}...J.g._&v.-o 4~-d5'--'-64-t~1(~-----+"ll.L..$g...L.f~/__ 9 R 15~- o 3 3 H q


Shirt: O.......,._O<L. Shirt: 'f~ -...J Shorts: ~~c.\."- Shorts: (\,.~c\<.....

Socks: ([)--.."\"f\fC Goalkeeper shirt: (l.~ 0....-c.--'A ('__ (Must comprise different colour to both P/imary and alternate coiour of shirt)

Socks: o '<""'~ ,_; ecreta., Goalkeeper shirt: ~~·ala (Must comprisf\~~M~ \o a~h primary and alternate coloUI of shirt) & women ~ eg ·

Men One set must compris<> at least SO% single colour per piece. Goalkeeper shirt must comprise different colour to both

rima and alternate colour of shirt.

,._, . I Name: ~.v.vo , --<>\t... "'(""""

5"' Hockey India Senior Men's Championship 2015( B Division) Pune, Maharashtra From 5"' April to 15"' April-2015

HOCK['( INO A ~ 0 sqs- ,e:,614-ENTRY FORM

: eam -PLAYERS

Shirt No. Family NalTJfJ First Name Date of Birth Age International 1-32 {PRiNTED- BLOCK LETTERS) [PRINTED- BLOCK LEITERS (ddlmmlyyyy) Matches

:1.. -:J A<i.,; A N T s~!Vu. 1-f ( ({"'. k ) 11-0J-qJ n f (, ~q ~ 2. RHJ'l!fl.f'l T SnJcnH DHTLLn!V oq-oJ.-95 Jo 16!q6 :'I ' Q 1"1 II H c; HT Ill 1'1 E 1.:? .S :L/1\1;;, H oi-62Af 21 lb~q~ 6 :1~c '· ,firvr .< ,n :24-ol- 1/1 22 tt.>q <3 7 Y!r:}O PRf£T Sr Nt'hH !25-1 o-"!5" '1 Cj I (,~qa, B UJ~nAIV0fF:'p c<:: T.!Vcn-H 1~-11-93 'll /(....6'oo 9 I1?Av"f k,, MAR )D-o2~q5 :to Jl;6o I

) 0 W<>Lilf'l" P .S·n./Vil1 ( c... ) o7-o"j-9J.. 23 1~60'}....

I J J'R-r.IVU 65 -o5 -'J6 ~~ 166~ H HRR~.,Jn/DER ~ 1!\k0l1 2o-o4-q:) 2.2. ·16~4-15 kA RRI\JOH."P ~:[tV(), H 25-il-q.f 1'1 0 {G~o{ 16' ! ·1( nNA f< .SHNiJrl (6:·1<. ) 14--lo -95 I q lt,6 0~ tB lJDHRrriPllEFT , \I 11/(n \1 18-ot- C12 1_2. i6Go':t

J...O .C:AtiiTA _ <;' '11\/fn H IJ-o)-96 ICI lhbO~ 21- fClv/FIR . .S 11\llh H (§-og.q+ 20 IG 6oq J-5 Br.; HA'\\1 -~ -rwu, l-1 J-5-oJ-Cff 2.1 ( -b 6 ~0 .iL6 I /11/) C. I< PilL Slf'lc?!i &1-;~-q:; f)o I 6~ If l ,'2_ C () }( (J/ fl. R t-1 S! 1'1Ci ft 11·-12 -"b) 3--t. !66/ 'l.

Team Manager: p ti/ !1 /{ S I/'-/ 4 f-/ Coach: q U IZ. C_ J-j I! R.. 1\1 s-;;.} Cf' 1-( Stand-in Manager: D 9 q I S'b - 'iS l ! I b~ ~ Assistant coach: . _ . , "' / 1 2 (Shall,otbeCoach.Ass•emtCoaoh<><T••m\>Dcto<l s;;:::: 0 "6 -:1...(\ S 7-7 (D\JT, 1 v ~·' Team Doctor: ~\._c)\~ . ~ Physiotherapist Ct"'c.e.\ •

I llhbl't J TEAM COLOU~S ALTERNATIVE COLOURS

Shirt: W h.(Ce Shirl: Dn~e._. Shorts: ~1--;_fti- Shorts: w~te

Socks: C:v-eA<."'\ Socks: 0~-~ Goalkeeper shirt: Goalkeeper shirt: (Must comprise different colour to bolh primary and aHernate colour of shirt) (Must comprise Different colour to both primary and alternate colour of shirt)

One set must comprise at least 80% single colour per piece Goalkeeper shirt must comprise different colour to both primary and alternate colour of shirt

Name: P~deJI ~m%1) Date:f/'tj/.5- NAMDHARl ~ BH~ NI SAHC',

Position: Signature: q. . tnt~!~ <-t"

-HOCKEY INDIA


DATE OF COMPETITION: __ 1_6__!\p_ril __ -:: __ ?§ />,[J_rii __ ?QJi) ____ _ STATE: SPORTS AUTHORITY OF INDIA

PLAYERS r- ------ --~----·---

r- Sh;;tT - Family-Name First Name ·---,---------~--

No. I {PRINTED- {PRINTED- BLOCK LETTERS Father's Date of Birth Hockey India ID Card

1 - 32 BLOCK LETTERS] Name (dd/mm!yyyy) No.

QUKHAN FARAZ · HIQMAT 16/05/1999 J(G/6 ULLA

ffi-''"~ NARVDESHVAR (_(,.I<·) RAM 02/12/1996 f6 6'1 :}--NARAYAN

8 SA VAN R. S. ._ On·~<·) RAM 11/03/1997 t6613 CHANDRA --~

l.:t KUMAR PAW AN LILA RAM 05/07/1995 /6611lf ( 5 BASAVRAJ SABANNA 15/12/1994 JG6Z-o I 6 KRISHNAN R. SENTHIL RAJENDRA 27/11/1994--i 166::2-1 o-<_ GOWDA VEERANNA SHIV ANNA 04/04/1995 166J.-2-05 JAGATH NACHAPPA NACHAPPA 30/01/1995 1~6 2-3 !f KARIAPPA M.M. MADAIAH 14/10/1995

166~+ M.N.

oq EKKA ABHAY . FEDRICK 04/02/1995 16 6~' llj MUTHANNA RAJA M. N. 26/11/1995 16 §_2-_b 1:6 NACHAPPA K.V. VENU K.B. 19/07/1994 !662-~ o8 MANPREET, DHARAM 21/07/1995

f~62-S SINGH

0.3 ASH OK . cc.' J RAM KUMAR 01/01/1994 16t,zq - -

o6 AN KIT SURESH KUMAR

02110/1994 I 166:$0 - .

C.A. SUB~AIAH C.A. 07/02/1995 to ACHAIAH , 6 r;.:u oLf CHANGAPPA C.N. NACHAPPA 25/05/1995 ! 6G::?.2. c.s.

11 SINGH NAVDEEP SATYWAN 18/1211995 If.> E ~~~ Team Manager: PIYUSH KUMAR DUBEY ~ Coach: HIRA STNO.H (j)Yl> 1-()66' ?,~ )

1'40:- oA(,8Cf 9LJYJ'2.6 I )663$) t--"r o: - 9 \f [/' J. '16 or'S' TEAM COLOURS ALTERNATIVE COLOURS

Shirt: ORANG!E Shirt: C..RA'I Shorts: OfiAHGt£ Shorts: 6t (I,_P,'(

Socks: ORI1N6tf 1 (JLOE Socks: r:? L 1,) [ --f "'-1 t-1 1 T £. Goalkeeper shirt: (3LACI<. cf- IJL-0£ Goalkeeper shirt: R£D 4 YfLLeW (Must comprise different colour to both primary and (Must comprise different colour to both primary and alternate alternate colour of shirt) colour of shirt)


Name: 3 US l{ n--;z1, . Q, , J[OTI t ' Date: 1 o-'-1~

Position: D l Q_ 8-C. TTI"f< Signature: ' - ..

Note: It Is mandatory for the partrcrpatmg team to be m proper krt wrth correct shrrt numbers and colors, farlmg whrch they will be penalized. Also, it is mandatory for a team to bring two sets uf Sucks. (to avoid any color clash).

HOCKEY INDIA

ENTRY FORM

COMPETITION: 5th Hockey India Senior Men National Championship 2015 (DivA)

DATE OF COMPETITION: 16April- 28April2015 STATE: 1NDjftN l.A(\Jl"--fRST'f

PLAYERS

[PRINTED- BLOCK LETTERS

TEAM COLOURS

Shirt: 5 k y £?:, l-- L1 C.

Shorts: L.l 11 '[ 1 6 Socks: S: /< V f3 L lA f~ 1-i f f tV Goalkeeper shirt:

Shirt:

Shorts:

Socks:

Goalkeeper shirt:

ALTERNATIVE COLOURS



One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both

Date:

R team to be in proper kit

they witt be penalized. Also, it is mandatory for a team to bring two sets of Socks (to avoid any color clash).

HOCKEY INDIA

ENTRY FORM

DATE OF COMPETITION· 16 April - 28 April 2015 STATE· L-.4.0 or: I _ND 1/t

Shirt No.

1-32 ,

L,

5

7

I~ I I

Family Name [PRINTED- BLOCK

LETTERS]

S !Nrnf....l

f31JN{) CIA

PLAYERS First Name

[PRINTED- BLOCK LETTERS

MR I N,P-L ( (,. k)

I) f-1'-ll:r tJ ~~'<:!IN (n f-1 ·

S1NCnH ·- ~ J A0 l<.noP (c)

_StN6J H O,cA?. P A RT!tf /)-- AIAta:mtrnniN I'Ylll.

2.@ IT!fiJIY1f!rtlt-H NITH!N ll. I1?4NN DINESH CJrk)

Team Manager:\{~L~YASA-t;. ~ Coach:

Father's Name

Date of Birth (ddlmm/yyyy)


6 6 ~-o 6 6 ~ J

. 6 G 83

Shirt:

TEAM COLOURS

tUiv'fe tJ,Afl c. tL. f'?yfq~

ALTERNATIVE COLOURS (_J b 6 ":f-4-) Shirt: ~ 'l"C 1:': Y)

Shorts:

Socks:

Goalkeeper shirt: (Must comprise different colour to both primary and alternate colour of shirt)

Shorts: t;3Aoet<... Socks: fb t(L>ck. Goalkeeper shirt: (Must comprise different colour to both primary and alternate colour of shirt)


Name:

Position:

Date l~{trJ:~ d.

Signature: ~W..v:tL-·---Note: It 1s mandatory for the participatmg team to be m proper k1t w1th correct shirt numbers and colors, failing which they will be penalized. Also, it is mandatory for a team to bring two sets of Socks (to avoid any color clash).

HOCKEY INDIA

ENTRY FORM

COMPETITION: 5th Hocke~ India Senior Men National Championship 2015 (DivA)

DATE OF COMPETITION· __ 16 J\)Jril- 28 ~ri/2015 STATE· A Nb H R A ~ FH!.. ")) eSL+ PLAYERS

Shirt Family Name First Name No. [PRINTED- BLOCK [PRINTED_ BLOCK LETTERS Fathers Date of Birth Hockey India ID Card

1 - 32 LETTERS] Name {ddlmmlyyyy) No.

r "-f}.._:J..... kAT I-lA RUfi·rJS R. ~EN 1 \JASA R Ao RAmARAo o 1-o'il-/~'8-'t 16 6' ':f--6 16 (YIU NA kv RV As Ho k R ~ T\i"l v 1 "ifrf/:~~ 2. %-~b-19qo t C; 6" :.v,_

Team Manager: 1) . S \J 'J:) 1-\- £ 13. Q Coach: :r . .B . 9 A N q A R. A :J V ,

TEAM COLOURS (..\ ~.~, >/ ALTERNATIVE COLOU~~ ' r

'fELLow shirt ~R.F-r;N, A·!YJo.i).e~ft ~~ Shorts: Ct I< e E N Shorts: v, L. (\c. 1<. (.PIG: 0'1 0 ) ~ IS Shirt:

Socks: '/ E' L L C> IN Socks: '/ B. LL 0 W \ 1 _ 4' y()

Goalkeeper shirt: {Must comprise different colour to both primary and alternate colour at shirt)



HOCKEY INDIA

ENTRY FORM

~-DATE OF COMPETITION· 16 April - 28 April 2015 STATE· .I-• ( .. r ·

PLAYERS Shirt Family Name No. [PRINTED- BLOCK

First Name [PRINTED -BLOCK LETTERS Father's

Date of Birth (ddlmmlyyyy)

Hockey India ID Card No. 1 - 32 LETTERS]

n Aii/J60M0AM SANtN t:>ICAJIT 0.5 S 1 N6 i-l 'H t~R. 0 iT 10 R..ANA MUN /~f-1

()/ '-fA/)AV Vi8\R..AM

TEAM colOURS

Shirt: C)'<"'":""-'!~ \ Q,.\ '" \<.. Shorts: W ~;-.., \ "-

Socks:


Name

6 '+00 '6%1

i 6 ::}o6

MAV(rtt'V 2:3 ·- I 1-'1.?

6'1-IJ

/ZAIVI <HAN RA 1>. /to I~( I 6 .:}--/3

Shirt:

Shorts:

Socks:

ALTERNATIVE COLOURS n . .

f.-, \l'i!j V.~~ ·' \ '-\<\ \ v'W (__(J\-,·\;;_


One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both I crimarv and alternate colour of shirt.

Name: Date j,f, \ ~ \&f ~~.~--'"'\ -~ \ .c( \·~

. ' .. ~ -Position: S1gnature: \ '- • • .. ef ....

Note: ltli§ ~t9!)'.. for the participating team to be in proper kit with corr~'i.b.Ktf 11111rli~s a'\1 ~~Jali}'tailing which fffl!l{~lilfOO p.!lf&fiz'lrd."AIW, it is mandatory for a team to bring two s~~~\!lill:~~'(lf' ar\'y color clash).

~.~.f.i.ftil.4''·~•1/ F.C.I.O.O.PUNE ~~~· '

I

• HOCKEY INDIA

ENTRY FORM

COMPETITION:


5th Hockey India Senior Men National Championship 2015 (DivA)

16 April- 28 Apri12015 STATE: Hockey unit of Tmilnadu

' PLAYERS Shirt Family First Name

Date of Birth Hockey India ID Card No. Name [PRINTED DBLOCK LETTERS Father's Name 1- [PRIND ( dd/mm/yyyy No.

32 - )

BLOCK LETTER

S] 1. 1-6-1-16 SHAN [ GK] HAMSA.K.M 1212CI989 PL/KAR/01950 /2014

3 'b :}/g. A.ARUL STALIN DAVID ARUNACHALAM 17CIOCI988 00

2 b:t--1 ~ R'ASHOK KUMAR RAMASAMY 251JiiCI988 00

14 I~ 7-IOf CHINGAPPA POONACHA 6@CI989 00

10 16 ;2.0 H.SHYAM KUMAR HARIDOSS 241JiiCI989 PLIUTN/1781//2014

15 11~1'l.l N.RAMESH · NALAMUTHU 1712CI982 PLIUTN/1776 /2014

18 W~l.'l. S.RAFEEQ SHAK MUNAWER 13[])CI989 00

8 I~ ';2.3 G.SURESH KUMAR R.GANESAN 29@CI990 PLIUTN/1780 //2014

17 WHA· A.ARAVIND AYYANAR 12CI l1991 00

5 -,~., ~ l-S S.PIEER ALLEN RAJESH SOLOMAN 15CIOCI984 00

4 i 1'4-~ G.GNANAVEL GURUVAREDDY 4@CI989 00

11 lb! 3~ M'VINOD RAYAR [captain] M.VEDAMUTHU 18CI1 Cl986 PL/UTN/1786//2014

13 ){, 2.~ V.SHANMUGAM VISHWANA THAN 14C11CI990 PL/UTN/1785 //2014

7 Ia' 1-Cf LAXMAN KARAN V.BASKARAN 12C12CI986 PLIUTN/1787/2014

12 b ~~0 V.RAJA D.VEERASAMY 4rliCI989 PLIUTN/1788//2014

16 IG~ 31 R.ARAVINDAN [GK] RAMACHANDRAN 13[])CI983 PL/PUD/01670/2014

9 ~~~3,") P.DHAMU. PARTHASARATHY 151JiiCI991 00

6 I f.!:}. ?.A -S.MANOJ SELVARAJ SCI OCI990 DO '

91?J-t~ b 73 bOb TSURESH ( I ' :t ~$) Team Manager: B.RAJKUMAR Coach:

(lt:'l-H) • TEAM COLOURS ALTERNATIVE COLOURS

Shirt: GREEN C.I-1~\Jr ~) Shirt: ORANGE

Shorts: WHITE Shorts: WHITE

Socks: Light green Socks: orange

Goalkeeper shirt: BLACK Goalkeeper shirt: GREEN (Must comprise different colour to both primary and alternate (Must comprise different colour to both primary and colour of shirt) alternate colour of shirt)

One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both orimarv and alternate colour of shirt. ·

/ v

Name: M.RENUKALAKSHMI Date: 12@[2015 '/i

Position:GENERAL SECRETARY Signature: " OJ]f~'-./

-

,~"~;

.. Note. It rs mandatory for the partJcrpatmg team to bern proper krt wrth correct sh1rt numbers and colors, fallmg whrch they will be penalized. Also, it is mandatory for a team to bring two sets of Socks (to avoid any color clash).

COMPETITION:


TEAM COLOURS

Shirt White & Red

Shorts: Red

Socks: Black & White

f--10CKfY lNDIA

5th Hockey India Senior Men National Championship 2015

~::;~:~~:~;.~~:~~;:~:J·---------~~:~~;~~~~~~~~~~~~--1]

Shirt:

Shorts:

Socks:

Red & White

Red

Blaclc: & White

ALTERNATIVE COLOURS

Goalkeeper shirt: Goalkeeper shirt: comprise different colour to both primary and alternate colour (Must comprise different colour to both primary and alternate colour of shirt)

Name: S.JALALUDDiN RIZVi Date: 14.04.2015

HOCKEY INDIA

ENTRY FORM COMPETITION: _ ~t_J:!_/j_()<;_k_<lY _ _IIl_~i'!§.l3_fli()_r__r>JlE'lrl __ ~§ti()IJ?LC::J:l§_fT1f>i()_rlf>fl_ill2_0_1_~JQillhL __

DATE OF COMPETITION: _ _1_§__~1l!)l_::-_~8 Ap!ii~O_J2__ STATE: __ K_t\~_~1\_TI\_~ ____ _____ _ ___________ _

Shiii No.

1-32

ffl"J5

~~a;: L

BLOCK LETTEF~Sl

First Name [PRINTED -BLOCK

LETTERS

ru""'"'d P E

Sonu u""""" 18 S ·

Somanna C K

' MUu ·~"""' .. kanth ( C)

....... IUs K

, ' ouu~" Su,.,;,.,,"

' 1 '""'uJ P V .~ qu«rll

'l:>owaa B M

Abhishe: H S

Hari - """'"u Thimanna P L

Kusha J .P

Umesh K R

Honnurswamy

Team Manager: Venkatesh B M- 9B't't3<l6oo'f r 11~'}:1-t:}

TEAM COLOURS

Shirt: Maroon

Shorts: White

Socks: Maroon

Goalkeeper shirt: Green (Must comprise different colour to both primary and alternate colour of shirt)

PLAYERS

Father's Name

Achaiah C A

, Subbaiah B B

"" •c• a~~d C K

llllfTllllalan V S

'-"~"'""" Kanth AT · Kaveriappa

l p s v

"d IC

""mi>~ H S

GK

.-. "'""'' J R Rajegowda

Mallappa N

Date of Birth (ddlmm/yyyy)

14 Nov 1992

28 Feb 1993

03 May 1992

02 Dec 1989

18 Nov 1988

09 Aug 1990

11 May 1987

15 Sep1989

21 May 1992

Hockey India /0 Card No.

I ;. 6 g 6'~64-

IA :+.A <r 26 Sep 1992 f £7o O

16Aug 1993 1 ::1-J;c, 06 Nov1985 II 'ii rO 25 Nov 1992 11 ~~ 01 Dec1993 ) t; -2-05Aug1991 ,; ~

05 Mar 1992 T b ~JA-

Coach: B. J. Kariappa - 9FJf5o97g.)? I

'-ALTERNATIVE COLOURS

Shirt: Yellow

Shorts: Black

Socks: Black

Goalkeeper shirt: Orange (Must comprise different colour to both primary and alternate colour of shirt)

One set mu~t comprise ~t least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both 'ana alternate co1our

~~.Yc~~ Name: Dr. A B Subbaiah f,:;.;..v ~ Date: 14/04/2015 ~ ~ ~ ~

Position: Han. Secretary j r; • ~~·~:,'1"~,~~--c~~~~ !!J!ii~~~lc~fajjingWilich_j Note: II is "' • for the_~ :in r01 I, kit wl!fi correct shirt ~ ao·lor:l, failing which they will be penalized. Also, it is ~f/ two sets of Socks (to avoid any . · cla~!h).

'\.'\.:~ "-'~~'

/67 J 61~

1 '7-fl

~

• HOCKEY INDIA

ENTRY FORM COMPETITION: --~l_fl __ lj_~t;_k_(ly__lll_~i<;J __ §(l_Qi<J_r}/l_(lll __ r-J<;]_Ii()_f1<;li__Qil_§_rT1p_i_()_n_~lli_[l __ ?_()_1_!) __ ([)_[\/_.'\2 ____________________ _

DATE OF COMPETITION: ___ !_~--~p_ril_::: ___ ?~--~pr.il_~~-1-~---- STATE: PUNJAB

PLAYERS

Shirt Family Name First Name Date of Birth Hockey India ID Card No. [PRINTED- [PRINTED -BLOCK Father's Name

1-32 BLOCK LETTERS {ddlmmlyyyy) No.

LETTERS]

1- I SINGH GUR IQBAL ~·K) MALKIT SINGH 0810811986 PUPUNI0189212014

~ /6 KUMAR MUNISH ( ~. I<._ ) BALWANT RAI 0410911987

3 KUMAR VARUN. j b_" .,.,. "' BRAHMANAND 2510711995 PUPUNI0188712014 . 'I ..,_

& SINGH BALJINDERI~ '=,~n GAJJAN SINGH 3010511997

/}_ SINGH VIKRAMJIT iA ?II SUKHDEV SINGH 0410111995

/0 SINGH GURMAIL C/);_ KABAL SINGH 3011211992

/2 SINGH SIMRANJIT '6~~~ PREM SINGH 2511211991 PUPUNI0189112014

13 SINGH DUPINQER DEEP/{,~~ f-BALWINDER SINGH 1010911994

II SINGH JASKARAN 161~~ RAJINDER SINGH 2710111994

1-; SINGH JASKARAN r't, ~ B6 DASWINDER SINGH 1410811991

1/r SINGH JAG MEET re ~<6'+ GURMEJ SINGH 1510311990

1__ SINGH MAJO~ H -isS SUKHDEV SINGH 21/08/1994

s; SINGH GAUTAIYIPAL II ~~~' SUKHWANT SINGH 01105/1991 '

IS SINGH PRABHQEEP It,')~ M SURINDER PAL SINGH 05/11/1992 ip(j ;/(IN jocrJt'J/.20/ ._ f, SINGH PARVINDER t"-iC 1 INDERJIT SINGH 10/04/1995 I"UPUN/01897?2014

7 SHARMA DEEPAK 6 '1-_9 '2. JAGDISH SHARMA 28/12/1990

125 SINGH GURINDER IA'}C/~ KULWANT SINGH 01/01/1995 fLj;Otm foo07jXJ!~ ~~ •v•' '' .,t.. KULDIP SINGH 26/12/1994

Team Manager: SANJEEV KUMAR (/6 ?9 $) Coach: BALJEET SINGH SAINI //6':1-~ l f!! 12 !-s31!Jv<J)'?S


Shirt: ..2-4-A'i( /3t.uE Shirt: ,(; t;..Pr ,q,cvc Shorts: lvh'/T II Shorts: A3 {_ u£

Socks: ;(J£..1J Socks: /,3 c:.~£



C'· I •• ;.--~~,

Name: PARGAT SINGH Date: 12-4-2015 1-\f)r·l-·.-:.._~-,, l~-·~1, 1:'-..-:'.J ' C>t -

Position: GENERAL SECRETARY Signature: (~-~·.:-"! c;;'(rp·;-nrv . . -- .. Note: It IS mandatory for the part1c1patmg team to be m proper k1t With correct sh1rt numbers and colors, fa1lmg wh1ch they will be penalized. Also, it is mandatory for a team to bring two sets of Socks (to avoid any color clash).

HOCKEY INDIA

ENTRY FORM COMPETITION: 5th Hockey India Senior Men National Championship 2015 (DivA)

DATE OF COMPETITION· _ 1_6April- 28__.1\_pril2015 STATE·

PLAYERS Shirt Family Name First Name No. [PRINTED- BLOCK {PRINTED- BLO~.:~ L:_ET].EijS Father's pdd~;e oflyyyBirt~, Hockey lnNdia ID Card

1 - 32 LETTERS] 1 L ~ loo{ ""' Name 1' ,mm y, . o.

·· 3 31NCJH DA-Vf"-ll)E~IJ.~W~· I'-\.S1Nl\'IIS''1el f"J<tr IPL(5SC{otSo82.of~ T ALl P-...p. 5 I<R.A ::1u, A Pie: l<iO. PAKR\1'. C\3 o~11<12.- PL/ssc/or-srr 2.® <

5 LAl<.RA M.UKES+116rq'q' ~.LA~ tlt;" tt t'l4C

'1 ftul'-lNErtGAPA Rc 8 t N ·. M__l,£_00/ MoiAIA 19 ot tqW) l3 s r NG 1-+ .:ntS P~E£.Tt6 Sol- ~St~+ ~~oeii<¥J~lrL/ssc/ot!Sol/.2 9 A-IND C..~At'-tl)AN..T6So,3.3.Ai<Nfr:>'Of-/r;3f9Cf/ ' 10 ' THA-Kc.tlZ V!SI-fkl-A- 16~o+ \.4->llf'-IOff 'a.b {o3 "191 PL-/~G/6!~~o/2~ lf ALl SAN~A-R. 16~0~ 1-f. ~ott!) v~M 1'1~ ' I~ f-JH-EN~fCA BtN~Y 16'i>o' Bt;MB'Icj::ILI O"} ['1'it PL(~cJor~tYf2~

>-------'--J3=!.__}[iiAJ>Il-Nq B'AM R\NcL SrN.G It 16 B-o'l !>.Stt'!<\~~<6 os-; "194 pc., sse{ or·:p=jg b , 14- StN'\1-t SU fc.H'Dt=V /6 <Oo R i$.StNlH olt/oi..ltt::tr:f],ir:::>c/~fJc..!o(9,()6f'J. I

/6 fJ o< (5 I<AN-iCALA \({S !+ Nlt ( G k.\ ¥.1\,W\IDIP 'a;r)olf/11112 /6 f/Jil I b Tl R~y .I'&N ACt:. · 7 e.-'f IAf.'ifQu- !'0/.s; t"l~l /68H l'f KllNA/Z_ \/-ARU"N ~.SI~~~~s-o\t<t9rpJ../SscjoiSt3J2<:> J6f6Jb..IB 6tN~ H LoyED£-E- P )....GrwHI o:L 10 l'i9.:l PL 5Scfe,r~9Jf,~ fo ~~12, I~ S'1 NGt lJ- 4_U R..P R_E::Eitf 1-J;,%·-Kitl ["f Of' f'i't3 ,, o..l~\

Team Manager: D, V ()"' '""'" 1 Coach: C · 'fV. :D~£VAJ)A.$:- CJ'<.tctcf£:'6'.U~>'1' c ~O"""D"A I 71~1 A :7fT t't - n-CJ-.,...2ClC.::U o~ PHY.StO- 71'.&. 7 H.lfJ><I'\. oY

TEAM COLOURS ( I b a, I.) ~ 17 ~ ALTERNATIVE COLOURS

Shirt: NA'\/'f 8l..Uf 1-JfTH f,l!4/J!~ Shorts: N 4V'/ !JL.t..tf?. Socks:

Goalkeeper shirt: ""IQ E Y / J,...ft:ft H-T f?>LU~ (Must comprise different colour to both primary and alternate colour of shirt)

Shirt: 6k.y BLttf:. tmru 1-JI:WlE·.

Socks:

Goalkeeper shirt: Ro '¥ AL B 1- U ~ (Must comprise different colour to both primary and alternate colour of shirt)

One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both rima and alternate colour of shirt.

Name: e. , f;3 . Dg V~!) ~ Date: I 3 r l..t-r ..2.e I s-Position: CJ:) A-e.~ Signature:

Note: It is mandatory for the participating team to be in proper kit with corrects 1rt numbers and colors, failing which they will be penalized. Also, it is mandatory for a team to bring two sets of Socks (to avoid any color clas;l).

HOCKEY INDIA

ENTRY FORM

COMPETITION:

DATE OF COMPETITION: __ :J_~~p_lj!_- 28 Aprii_~Q_1_~------ STATE: HOCKEY ODISHA ·----------------------------------------------------·

Shirt Family Name First Name No. [PRINTED- [PRINTED-

1-32 BLOCK BLOCK LETTERS LETTERS/

16 GULlA AN KIT

2 SINGH ABHISHEK

3 TOP PO DILLIP

4 LOCHAB AM IT

5 BAR LA ALOK

6 MINZ DAVID

7 TOP PO SUNIL

8 SINGH UDAYPRATAP

9 KUJUR TEOPHIL

10 TIRKEY AMONMIRASH

11 BAR LA ARB IN

12 KANDULNA RAJ IN

13 LUGUN DEEPAK

14 TOP PO JOSEPH

15 MIRZA I SAD

. 18 PAL . AMAL

17 YADAV RAHUL

1 TIRKEY SUBODH

Team Manager: RANJAN KUMAR DAS /b); 2>5

TEAM COLOURS

Shirt: YELLOW

Shorts: YELLOW

Socks: DARK-BLUE

Goalkeeper shirt: GREEN (Must comprise different colour to both primary and alternate colour of shirt)

PLAYERS ~

Date of Birth Hockey India ID Card Father's Name (ddlmmlyyyy) ~I).

RAMESH GULlA 26.08.1990 '{; ~ ~~~ BHANUPRATAP 17.03.1991 16 01f-SINGH

THOBOTOPPO 04.02.1993 16 ~, 'h NARESH LOCHAB 17.01.1995 lll61tlJ OSCARBARLA 17.11.1994 \66.2.0 JUNAATHAN MINZ 03.06.1994 16<1>2-1 FLORENCE TOPPO 15.03.1992 f6~2l. RAM SEVAK SINGH 18.02.1993 16 s~ 2. SULEMAN KUJUR 01.10.1997 16 e, )..4 HEMKULAR TIRKEY 18.11.1993 16lll 2~ JAMES BARLA 02.12.1993 16Ci1l.~ SILAS KANDULNA 19.06.1993 .~~2. GEORGE-LUGUN 10.09.1994 16!~2 ANTHONY TOPPO 10.02.1995 t6B'l ~ ~ MD. IQBAL MIRZA 19.01.1989 I 6 13..10 SUBASH PAL 28.04.1991 I 613 gJ · RAMJANM YADAV 25.05.1990 ·1 6 B32 BUDUTIRKEY 05.05.1995 I 6<6 33

Coach: PRADEEP KUMAR SARANGI I 6~341-

ALTERNATIVE COLOURS

Shirt: GREEN

Shorts: YELLOW

Socks: DARK-BLUE

Goalkeeper shirt: BLACK (Must comprise different colour to both primary and alternate colour of shirt)

One set must comprise at least 80% single colour per piece, Goalkeeper shirt must compris"e different colour to both primary and alternate colour of shirt,

Name: PRATAP SA TAPA THY

Position: GENERAL SECRETARY

Date: 13.04.2015. ~ CPrat;;.7J:> Sat:patliy

Ger .. S~cret;:,ry . Hockey Odisi~a

Signature: Borabati s~adlum _ _ C~uo.ek

Note: It Is mandatory .for the participating team to be in proper kit with correct shirt numbers and colors, failing which they will be penalized. Also, it is mandatory for a team to bring two sets of Socks (to avoid any color clash). ,

HOCKEY INDIA


DATE OF COMPETITION: 16 April - 28 April 2015 STATE: JHARKHAND

Shirt No.

1-32

Family Name [PRINTED

BLOCK LETTERS!

PLAYERS

RrstName [PRINTED- BLOCK LETTERS Father's Name

Date of Birth (ddlmmlyyyy

)


1• 1 CHAUDHARY ARPIT(G) € 2,3 (' PRAKASH CHAND 03/3011992 ~~~~~----~~~~~~~~~~~==~~====~~~~===-~

NOIDCARD

I). 2 LAKRA PAWAL ) 6 9J '3. 1-- DULLU LAKRA 02/02/1984 NO ID CARD

5~~-3~_-47.K~U~MAR~~--~MAH~E=S~H~~,~b~~~~~s2--4~~~~~~~AR----~SH~E~Noh2~W~00~/~1990~+--..N~O~ID~C~AR~D~~

j0~~4~~XAXA7.7~~--~AN~I~L~--~/~8~~~~·CL---rJ~O~H~N~~~~~--~mY-.~~1~99~2~--N;-;O~ID~C~AR~D~~ ;j·~~s~47K~U~JU=R~~-+AR~~~N=D~~'~h~~~~~~~~Q~~B~EN=E~D~IK~K~UJU==~R~~~~~1~==4-~N=O~ID~CAR~D~~ ~ ~~6.--~H::::EM=B::;-R;-:O--,-M_-t-:AN=S:-::H=EL---rTE-nM,....--l.;f-"' ~1'-IL 9!4:.!.·-1-··/ ----,.,-+J;:;;O-;;R-;oO""'H'""E"'"'M""B"'R""O""M-;-;--r0:;-;1;-;:/1:;;1:-;:;/1""99""3+-N;-;0;,-:;ID~Coo-AR~D~~

\g tj7~jjD~O~D~RAI§~·~djN~O~YE~L~I6~~·'0.,tt~,u2-~"~'~,~~j'j,)~f..S~lU~LE~MAN~~D~O~D~RAI~t1~8/~1~2/~1~993~t=N~O~ID~C§AR~Dt=j 1'1' 8 SINGH·/6'l>'f3 gJ:IAfiiRAJ ·/hi c RANBIR SINGH 07/0311991 NO ID CARD

(, 9 TOPPO MANISH J b 8 44- KALMATH TOPPO 15/0711~ NO ID CARD ] f. ~'10.,---t-;S~IN;-;G;;;H....---1-;S::;-AN~D~E::;:E::;:P!-(,.;G:',-) "'-E.L..%.,;-\--.$-;--+A"'VD=-cH""E""S~H""'S:,;IN-;:;:G""H,.-t.,-04/06/="'1~988~~-N;:;:O;,-:;ID~C"""AR=D~~ J- 11 XALX0/(,84-6 CHANDRASHEKHAR (C) DENISH XALXO . 26/12/1981 NO ID CARD ~~~~~~~==----~~~==~==~~===+======~ T 12 TOPNO ANUP · 6 '(;4 :j.- SUSHIL TOPNO 02/08/1991 PUfHN01854/2014

13. 13 KWUR DEEPAK I b 4-- SUMAY KWUR 09/0111989 PUfHN01853/2014 ,,~~14.-+.B~E~C~K~--~I-;RA~V7.1~R:-::O~S~HAN~~~~6~Y}C~~~K~U7.LD~E~EP~BE~C~K~-+1~9~11~2/~1~99~5~--N~O~ID~C~AR~D~~

~-~~15~~M7.1~NZ~~~-r.B~I~N~IT~--~n~(~~~~O~~S~I~PR~~~AN~M7-INZ~~~rnY~1~&7.1=99=7~--N~O~ID~C~A~R=D~~ '3 ~-;c16o;--+.:;Hc;;EM=Bc;-R~O-M __ t-S;::-O::-MA=~-f*/1 )~1(,!_,_{;j!-J---4-:LE:-::Dc:cW:-::A:-=HE~M:=Bc:-Ro-0-M-+~=1:::-0/"'19l;la=+---:-N:-:::O--:ciD::-o:-CA""R=Do--~ JJ·r-~17~~D~O~D~RN~---+-R=-O~B~E~R~T~f~0~~~2-~--+.:;JU~NA~S~DO~D~RA~I--I-;1~W~021~1~==+---:-N:-:::O~ID~CAR~Do--~ \.2-· 18 LAKRA SANJAY I 6 ~0 S ~. ESIDOR lAKRA 03107/1997 NO ID CARD r----L------~L-----~~~~~L_ ________ _L ____ ~L---------~

Team Manager: SANJAYTIRKEY(M/No.-9693112447) Coach: JAY ANT KERKEITA (MOBILE NO. 09835975173)

Shirt

Shorts:

Socks:

r I b 'ti .>~.J TEAM COLOURS

LEMONYELLO

LEMONYELLO

GREEN

Shirt

Shorts:

Socks:

r 1.1: 'i! cA-)

ALTERNAliVE COLOURS

REO WHILE

REO WHILE

RED

Goalkeepershirt ORANGE Goalkeepershirt BLUE (Must . comprise diffa a II colour to both primary and (Must comprise different colour ID both primary and alternate colour alternate colour of shirt) of shirt)

One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both primary and allemale colour of shirt.

Name: BIJAY SHANKAR SINGH Date: 1010412015

Position: GENERAL SECRETARY Signature:,~-~ a ·-&vvl Note: H is mandatory far the pailicipaling team to be · correct shirt numbers and colors. failing 1llhich they wiD be penalized. Also. it is mandatory for a team to bring two any color dash)-

STANDBY:- ~~-~o . ·or .,..:.\ General Secretary _.~...., Hockey Jharkhand

~1\)1(\'\ ~~

_. SENIOR NATIONAL HOCKEY CHAMPIONSHIP, PUNE

M- p, H-ll· !1.H6f ~ S.NO.\SURNAME NAME FATHER'S NAME T.SHIRTNO.

1.SAMAD ABDUL r ( ${,$/, ABDUL WAHAB 01 C..-~-2.KHAN IKRAM 16 SS" ~ A.W.KHAN 31 V.-~· 3.UIKEY

4.KAUSHAL

5.YAD/W

6.HUSSAIN

7.SINGH

8.KUMAR

9.YADAV

10.1QBAL

11.ADHIKARI

12.KHAN

13.UDDIN

14.CHOUDARY

15.KHAN

16.QURESHI

17.QURESHI

18.SHAFIQUE

DEVESH

I 6 10~8 NIKKY /6S~q BRIJES!-1

0 16v6o SHAKIR 6 $(:;/

MOHIT· /6%3

RINKU/G 86..,_ IRSHAD-_160t:£

TARUN/{, U6

RAM BHARAT 03

UIKEY

ANIL KAUSHAL 04

LT.BHARAT 05

KUMAR YADAV

MUNNE KHAN 02

KARAN SINGH 10

MEHENDRA 09

PATHAK

LT.UPENDRA 08 YADAV

LT. IQBAL 06

ADHIKARI 07

AAMIR RAFIQ UR 11 I~ ~61- REHMAN

FAIZ /6 B 6 ~ RIYAZ UDDIN 13 VIKAS /C.8CCf RAMPALSINGH 17

SARFARAZ/6 g:1l SHAJADAY KHAN 15

IZHAR ·/6B~/ AHSANQURESHI 12

MUNIS' MOINUDDIN 16

/6 B ?-2- QURESHI

AAMIR I b g 13 SHAFIQUE 14 AHMED

M !+J-.111?. h-/, ::j It;'~ 1 N?dt ,

( !6103--$)

(J) 1J; /J M , c 61 o 4 r_ - s ry . tJ/ v s _ > )1.; reT _5/lotf-11' · ~- p!i~L f3,1Y'fi.

0J feo/-~IJ-tf.7>· -f)!JR..tc.fJJLffl. ~Y-;/2._1..

>• cJc.s.

o C( ~ LS- o 7 "\ r'2--<l'

rz-~0 -~ :r~ 2\ ~

"' .(. .

DOB

27/11/1989

01/08/1992

15/01/1993

16/10/1991

20/12/1993

12/11/1993

24/07/1993

05/10/1992

13/08/1992

25/12/1990

22/03/1995

03/05/1995

24/02/1995

16/08/1992

14/06/1993

08/07/1995

09/04/1992

02/02/1994

~ HABEEB HASAN

c 16~!1"1-)

-HOCKEY INDIA


DATE OF COMPETITION: STATE: MUMBAI

PLAYERS

Shirt Family Name First Name Date of Birth Hockey India ID Card No. [PRINTED- BLOCK [PRINTED - BLOCK Father's Name

1-32 LETTERS] LETTERS ( ddlmmlyyyy) No.

1 DIXIT SUDHIR (GK) RAJU 5-9-1990 I 6 (6 9-6 2 SINGH VICTO NAKTA 12-3-1991 b ~::) _&_ 3 PATIL MAYUR. SHIVAJI 3-9-1990 6!0~2 4 PEREIRA TYRON· c~) THOMAS 25-9-1987 ~ ~ 11-Cf 5 SINGH AMBIKA ASH OK 26-11-1991 '6~~0 6 KEISHAM ROSHAN RANJIT 1-3-1994 6 ~BI 7 SINGH MANPREET MANGALSINGH 23-12-1995 16<0~'2-8 WALMIKI DEVINDER SUNIL 28-5-1992 U'><bB~ 9 VALMIKI ANUP AMARPAL 26-7-1994 '16'0'0+ 10 SHARMA RAJAT MAHENDRA 22-11-1995 (6 1310~ 11 GOSWAMI AM IT MAGANLAL 11-7-1991 It BS~ 12 JADHAV JAYESH BALARAM 26-12-1984 e. co~~ 13 NANDANOORI NITINKUMAR CHANDRASHEKAR 28-5-1991 /6 Y>Yl& 14 REMEDIOS CONROY DIGBY 10-1-1980 6 B coo, 15 VESSOAKAR JOSHUA THEOBALD 22-1-1988 lb f{)~O 16 PARDESHI NIKHIL NANDLAL 30-10-1995 I(;, 'h'1 f 17 THOKCHOM KIRAN KUMAR INGOCHA 1-3-1994 163o/2.. 18 KARKERA SURAJ (GK) HARISH 14-10-1995 IG~q3

Team Manager: VERNON LOBO 16<oqs) Coach: MUKUL PANDEY{\ 6 B'l +)

Shirt:

TEAM COLOURS

Sky blue & Maroon

Sky blue & Maroon

blue

Shirt:

ALTERNATIVE COLOURS

Maroon & sky blue

Shorts:

Socks:

Goalkeeper shirt: Fluorescent green (Must comprise different colour to both primary and alternate colour of shirt)

Shorts: Maroon & sky blue

Socks: maroon

Goalkeeper shirt: Fluorescent Orange (Must comprise different colour to both primary and alternate colour of shirt)

One set must comprise at least 80% single colour per · 1

alkccpcr shirt must comprise different colour to both rima and alternate colour of shirt. ' \\ \f: !'

ff ~. e· ........ ~Ruby--~. ?>clatlon.L d: Name: MANGHA SINGH BAKSHI ~ """17 ,

~ ~ ' Position: PRESIDENT ~* Presid<'-t.

Note: It is mandatory for the participating team to be 1 it witlt'e-Oi'tect'sliirt numbers and colors, failing which they will be penalized. Also, it is mandatory for a team to bring two sets of Socks (to avoid any color clash).

HOCKEY INDIA


DATE OF COMPETITION: STATE: Maharashtra

PLAYERS Shirt No. Family Name First Name

Date of Birth Hockey India ID Card 1-32 [PRINTED- BLOCK [PRINTED- BLOCK Fathers Name LETTERS] LETTERS {ddlmmlyyyy) No.

1 CHIKTE AKASH GK ANIL 24/07/1992 lbB'¥6 _ 18 SOLANKAR AVADHU.T GK SHRIBANG 20/10/1986 ) 6 lbq 1-3 RAJBHAR KANCHAN LOCHAN 04/01/1987 J613 '1'6 15 TIRKEY BASANT MARIAN US 12/02/1993 t. ~a, q 4 SA WANT SAN DEEP CHANDRAKANT 25/08/1984 16'H>o 17 NAIR VI NOD GO PI 07/08/1988 16 CftJ I 14 KAVRETI GUNENDRA JEETSINGH 16/08/1991 6 Of() '1. 16 KEDARI RUBEN DANIEL 17/12/1991 ~6 Cfb s 12 SINGH LOVEPREET KARAMSINGH 29/01/1994 'tJcto4-7 CHETTY ASH ISH OM PRAKASH 07/02/1992 'SdJo<t 9 ALAM AFTAB ASGARALI 04/07/1993 ~~ cto~ 6 SHIRODKAR ASHISH vc ASH OK 27/08/1988 1 6'1o ~ 2 EKKA RAJENDRA PHILMON 29/01/1992 f_60,o~

celf /60j t6Cfl

5 PILLAY VIS HAL c RAJ AN 01/07/1989 PLIMAH/01734/2014

13 SWARNKAR NAVNEET SHIVKUMAR 21/03/1987 PLIMAH/0 1736/2014

10 KAMBLE VI NIT NANDKUMAR 23/08/1994 ftJCfl/ 11 LINGESH ASHUTOSH 18/06/1994 I£C, l 8 SHAIKH RAZIK RAZZAK 05/08/1995 't6Cfl3

Team Manager: NIRANJAN EKKA- 9637176706C 169/ s) Coach: AJIT LAKRA - 9860480568 (.1 ' q I+) 1'~1 '1-S "' · .<":'lo1J-'\<-A K215'l-\Nt-, ..J -k_./)"'-v--"-

-----TEAM COLOURS ALTERNATIVE COLOURS

Shirt: ORANGE I GREEN Shirt: ORANGE I BLACK

Shorts: BLACK Shorts: BLACK

Socks: ORANGE Socks: BLACK



Name: MANOJBHORE Date: 1510412015

~y Position: GENERAL SECRETARY _/c'c.KE"~ Signature:

Note: It is mandatory for the partie ~~. L_ ··~in ~roper kit with correcf4AN I .r,. nd a~fl\~ whicn they will be penalized. Also, it is m~~da ~~zo·; bring two sets of So<lt\6JMo S!D~b.oS!i: ;fAR

4i ~ HOCKEY MAHARASHTRJ\ "~har'3-~

HOCKEY INDIA

ENTRY FORM COMPETITION: -~!_i:l __ ljoc_k_e_y__lll_Q@_~I3_1liQr __ rvl13_11 _ _f\j§_!i()_ll§_I_C__h_§llllP_ion:;;ll_~_~Q1~\_[)i1J_f:-2 _________________ _

DATE OF COMPETITION: _16 April_::~!!_[\_p_ril 2015___ STATE: HARYANA

PLAYERS Shirt Family Name First Name

Date of Birth No. [PRINTED- [PRINTED -BLOCK LETTERS Father's Name (ddlmm!yyyy 1-32 BLOCK LETTERS]__

I 1 SINGH JASBIR (.£! ~? r:;,.c_) S.MAJOR SINGH 31/12/1985

2.. 2 SINGH SATPAL. MAHANDER SINGH 02/09/1986

to 3 SAROHA JITENDER OM PARKASH 17/11/1985

13 4 SINGH GAGAN DEEP S.DILBAG SINGH 03/12/1990

" 5 A.JMANI SANJEEV VI NOD AJMANI 14/05/1987

tLr 6 MOR PARDEEP DHARAMPAL MOR 03/06/199:-

I" I 7 I TEWATIA RAVINDER DAYACHAND TEWATIA 20/05/1990 ! -----

I 1 SHIVDEEP 7 8 i / SHANKARLAL 29/12/198~

I Is- L __ 9 I KIJMAF~ ..., AMIT· ' JASMER SINGH 21/11/199'

I I ~+----- A:J(~( / P•RTAP SINGH 96

3. 11 ' ~ ! I ARJUN KARAN KUMAR -i13712-1199 ·l

-~----

/Z..., 12 ANTIL MAN DEEP j BALWANT SINGH 10/1111988 I ; ~ .3 I 1 BHARAT I JAGBIR SINGH -s;~ ~!'~-t SINGH JAGWANT 1 SURAJ MAL I 17ii2

---+-----4 /7

"! )...(}

--i 15 ' NAVEEN ' '

KRISHAN 22/'12 L-••-•••---+-- ------

16 I SINGH GURJANT BALDEV SINGH 26/01

17 SINGH i RANJIT S.HARJINDER SINGH 18/07

i 18 KUMAR MANISH CC-t 1L) NARESH KUMAR 28/09

Team Managej: MANJEET PANWAR <fo3o/Jo<>533 poach: RAVINDER SINGH {.. Cf 5. L(l AJ_ • f1L~'l..llrl

I /'-'V TEAM COLOUR's ""'\ '

' ! Shirt: WHITE I

J Shorts: WHITE

I Socks: ORANGE

I Goalkeeper shirt: ORANGE I (Must comprise different colour to both primary and alternate

1 colour of shirt)

~

ALTERNATIVE CO LOU

Shirt: WHITE

Shorts: WHITE

Socks: ORANGE

Goalkeeper shirt: BLACK (Must comprise different colour to both primary and alternate colour i of shirt) '

One set must comprise at least 80'% single colour per piece. Goalkeeper shirt must comprise different colour to both primary and alternate colour of shirt. ------------------------ .. ,

1 Name: SUNIL MALIK Date: 12104/2015

' I I • H :

I Position: GEN.SECY. Signature: _, ___ ?V __ __ _ __ ___; Note: It is mandatory for the participating team to be in proper kit with correct shirt nU e--;g-~~~~ ,wh!cb th y will be penalized. Also, it is mandatory for a team to bring two sets of Socks (to a' o\il~r'ililli\\")'3 ·. ,_, ,-y

Hockey Ha,·· ·'1

Sonepat

HOCKEY INDIA


DATE OF COMPETITION: ---~§_-~_t:!l_-:-___ 28 ~~ll __ 20_15 __ STATE: HOCKEY GANGPUR-ODISHA

PLAYERS Shirt No. F_a _ _r'!_il!._ Name First Name

Date of Birth Hockey India ID Card No. 1-32 BL/Jc'K'~ '_...)_-[PRINTED· BLOCK Father's Name

LETTERS {ddlmmlyyyy)

03 EKKA /6 tf 3.5 DINESH ~K EKKA CHARLES 09-04-85

02 XALXO {G'f.3E ~ YAI 1

01 TRIPATHIIl'fl ~ I'UA ''\TI. ~K_ TRIP A THY RAVI SHANKAR 23-04-88

12 EKKA 169 3,g AMARDEEP EKKA 31-03-89 ; 11 XESS tf>Cf:b'/ BANAMALI XESS CHAMRA 17-04-86

06 I UJ-'J-'U f{, 1-+o BIKASH 1 ur-r-u POl IC:AR 08-01-87

17 MINZ f ~'f+/ ROSHAN j£) MINZOHMA 21-10-87

05 RA~I A.f()C(4-l SAROJ RARI 1\ANIL 10-10-94

04 LAKRA f6'f4-, PRATAP ~.c, LAKRA MICHEL 09-11-99 PL/GAN/00839/2014

14 I AK~J\.~~lltAA .JEROM I AKRJI, JULIUS , .. '"1"7"7"

08 SURIN lb't~ "<>AM ''\Y ~ .. -~ SURINJOHAN 10-12-96 PL/GAN/01226/2014

4 1&- 15 KIS~ ...iliA MAI\Ir.AI '' rACHARO .. 16 EKKA ~~~4-; RAJ EN EKKAPANDRU 20-06-91

10 MINZ t€CflH Wll!::nl\l MINZ 21-10-87

07 LAKRAfl'14C DEEPAK THOMASLAKRA 20-08-86

09 XALXO J 6"(~( SANJAY XAIXn 01-11-99 P' ... tL 18 KI-IJ\.LKi-10 RASANANDA KHALKHO BANDHU 03-07-98 PL/GAN/01222/2014

( '-

) 13 MINZ JS'f$2. AMULYA MINZJOSEPH 16-11-89

Team Manager: SURENDRA BARI A.

" Coach: LAJRUS BARLA(9437245245) ( \bq S 3) 11

CjLf3]:L._OD3 b(::{t{;9..S.It) fJit'/SIO ~ Nif~~f; /dcuz · ~-~

TEAM COLOURS '--. ALTERNATIVE COLOURS

Shirt: YELLOW Shirt: GREY

Shorts: BLUE Shorts: BLUE

Socks: NAVY BLUE Socks: ROYAL BLUE

Goalkeeper shirt: BLACK Goalkeeper shirt: YELLOW (Must comprise different colour to both primary and (Must comprise different colour to both primary and alternate alternate colour of shirt) colour of shirt)

One set must comprise at least 80% single colour per piece. Goalkeeper shirl must comprise different colour to both

''"'" .oo ''"''"' '""'" ·~ --

Name: DEBASISH GOUDA ~ Date: 15.04.2015 "i _!:f ~ . ::/J "· General Position: SECRETARY GENERAL Signature: HOCKEY·G~;:i"'•''" lA Note: It is ... g .. ug•u•i_for the,,~., .. J_te~ ._,. ·kit with correct shirt 'and_ co ~rs: failing which they will be penalized. Also, it is mandatory •u• ,.,.,....., bring two sets of Socks (to avoid any color clash).

1)Rot:Jl.-b

I b cy b I - I h0 ~ ~ HOCKEY INDIA ---


DATE OF COMPETITION: 16 April- 28 Apri/2015 STATE: AIR INDIA SPORS PROMOTION BOARD

Shirt Family Name No. [PRINTED-1.- BLOCK 32 LETTERS]

01 SINGH

04 PILLAY

05 ARJUN

06 TIRKEY

08 P.R

09 SINGH

10 DAD

14 PIMP ALE

15 \,jiKKALIGA

16 D'SOUZA

17 CHINNAPPA

18 ALEMADA

22 SINGH

23 MUTHANNA

24 SINGH

25 PILLAY

27 PILLAY

29 QURESHI

First Name [PRINTED - BLOCK

LETTERS

PLAYERS

Father's Name Date of Hockey India ID

Birth Card No. (dd!mmlyy

yy)

GURPREET /6~ 6) S.SUKHWINDERSINGH (,.C, t<_J 01.01.87

VIKAS VjSHNU/6'f6'J- VISHNU PILLAY 20.11.89 PLIAIR/00042/2013

HALAPPA ·/6-q[, ~ B.K.HALAPPA 17.10.80 PL/AIR/0198512014

PRABODH '16'f( 1- WALTERTIRKEY r:_c..j 06.10.84 PL/AIR/0199212014

AIYAPPA J tq 6S' RAJAPPA PARADANDA MUTHANNA 05.09.93

SHJVENDRA J6Gl 66 JHAMMAN SINGH 09.06.83 PLIAIRI0198412014

SAMEER ~~·~q~~TL_~K~H~U~D~A~D~A~D~~--------------~~2~5~.1~1~.7~8-+~P"L/~A~IR~/07.1~9~11~20~1~4 GIRISH · qJi8 RAVAJI PIMPALE 06.05.83 PLIAIR/01987/2014

SWAMY VINAYAJ6q6q B.SWAMY 24.11.85 PLIAIRI0198912014

ADRIAN -bq7-0 ALBERT D'SOUZA r.l-t \(_) 24.03.84 PL/AIR/019612014

NIRMAL A:D I ;-g 3-1 DINESH A.S 01.07.94

CHEEYANNA BOPAIAH BOPAIAH Jc Cf ~0 05.11.89 PLIAIRI0199712014

AJMER -~~q ~')... S.LAL SINGH 23.09.87 PL/AIR/0199512014 MOHAN 0 Cj =r~ MUTHANNA BOLLACHANDA MANDAPPA 24.05.88

GAGANPREET ~~q~lj- S.GURBACHAN SINGH 15.10.94 PL/PUNI000821201<

VINOD VISHNU 16 q:rs VISHNU PILLAY 05.12.88 PL/AIR/01990/2014

VIKRAM PILLAY /6qf~ VISHNU PILLAY 27.11.81 PLIAIRI0198812014

ARMAAN \ {) ~ :t+ REHMAAN QURESHI 01.01.95 PL/MPA/00087/201 2

Team Manager: VINEET KUMAR r \b Cf ~) Coach: DHANRAJ PILLAY

TEAM COLOURS

Shirt: ORANGE WHITE

Shorts: BLACK

Socks: BLACK

Goalkeeper shirt: BLACK (Must comprise different colour to both primary and alternate colour of shirt)

ALTERNATIVE COLOURS

Shirt: WHITE ORANGE

Shorts: WHITE

Socks: ORANGE

Goalkeeper shirt: RED Extra Shirt- BLUE (Must comprise different colour to both primary and alternate coloUJ of shirt)

One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both primary and alternate colour of shirt. /1

Name: VINEET KUMAR Date:i5.o;.201'~ I~ \u._ -Position: MANAGER Signature: \ {S alfi()

Note: It is mandatory for the participating team to be in proper kit with correct shirf'numbers and colors, failing which they will be penalized. Also, it is mandatory for a team to bring two sets of Socks (to avoid any color clash).

COMPETITION:

HOCKEY INDIA

,S '):_\,\If~~

lbLf~f- -1?-00~

ENTRY FORM

__ 5th Hockey India _§er1ior Men National Championship~Q_15_H?l~8.L. __ =---·-------· DATE OF COMPETITION: __ 1__(?_6P_rjL::_ __ g~_6P.riJ.~Q~- STATE: ____ _'0 __ 1_£'1 ................... ····-·----······

PLAYERS -Shirt Family Name First Name

No. [PRINTED- BLOCK [PRINTED- BLOCK LETTERS Father's Date of Birth Hockey India JD Card .

1-32 LETTERS] Name (cd/mmlyyyy) No.

r I (hc:!!,u\ ~~ ht- '-J -E' ""\:-__ ( u K. w ~ .. I I •• L 1·11.n.'"" R\ ) 6 ( 89-2. 1\<\ .l .......

"'\\. \ "'""" ~-.[' a\o....,\.t Ln~. 1"14. ~ .... (l!'l: I b ( rare IS I C..~, , ~, \.\£ \<:._ c.....~--N.~\\ ll.,\TNbl \.1 I ot.. o'\-~' "1'\ $' 1';)---000 [{., .~,... ..... ~~ .S\J~~\. 1>~.'1 .. .1.. h'l..\'2...._1_ '\ '\ 'l. J ::H){) l s- ~V\f'\'0~ ""-l."L k~~ ~..f.''""'· I\ '" .11:\'\~ \ 6 c "1 R Q·n"f. f-::1...\'r\"t:"\:-\ l!.k ~ ..... II'~ .r."l. • "" !;;> '1. I~ let q_t 1--'::1, 1".\~~\-\ ~'G..E~?.~ ""· ~-· ~- Ill ~"L .. I"H'l. (; g_g.n_

" I""'\" ...._, ''- • '-' ".C..\)~{:\~\-\ ~k_ • .;\...._,\_ tl\. ti!> \ "1."1 ~ +{l1-5 4 I '-1. c..~ i::\,, 9\~~\,j~ 'tl.. 'l" ,\.~" 1 \G.G\. \C\C\~ . '

11 \<.\.\\)...~ ~ \""\"\' Q h\_\,\_ 12'\\n.l \'\'\'\ 1 6 C\q·.:} c. , ... \-\f\~ T 't"\ ~ C>.. ~ l,l.. \.\ 13.'<\\ n~ l<'t'\' G0t2.. t2 '-t!~\<..~~ S\J~'t\ r'\1 .~ • h. I I t.\i7\ \'\ '\'" l:t-003 }L, I\!PA~\ \ C>. I .,.. 1' .•. j,

cl\ru '~"'""' ~ 6 ~'F1 17 !~t1.1..1~R~ .... " . , ... .3,"' - -z_.~ -t:.\\'ll \'\~& '_9:0 0 '2. 13 I \<., "" "' " c;""'<)C.,~ t Q,l. _, • .l. 1.-.ci"\\Clf\'l, -rt;qqB 7 ~f>..~~'J ~£'E.~{.\~ 'J.P,'tJ • ..1. CY\ \ tJ':;\ \'\"\ '< 6m--10 ~\.\w "'"'1.~~ \'\ H:A\Q~ ~~..,..\ Ul • .1. lj.(.,\)\, \q~ '\- ,____,_6__9 q -:_

.2.'l. ::y.,..._\f)£'1 '()1"1"""-~\J \._~IL.) ,, ~-· g_ ..\~" l'l .\U'l.'!\4- ~a+ --

Team Manager: f'll'\ 1""''1 \1 i S 'i "'' ~"' U ~ach: \.<~3~\q_\\ ~1:..~\\~\\ "!Lt5o7oqqlo f f.J.I.Lo9.·•=' Je~.v ( , ~"' b ~ Jl.. v b ~1 -," · 1 '"1. .... <" ~--

TEAM coLouRs u( 1 '}O o6 ) ALTERNATIVE COLOURS '-1

.

Shirt: 8...\1.1..(.. Shirt: R"'-.\. Shorts: illu.t.. Shorts: w\-.l. ~ Socks: '1~1...:> Socks: '!1...---· Goalkeeper shirt: · Goalkeeper shirt: (Must comprise different colour to both primary and alternate (Must comprise different colour to both primary und alternate colour colour of shirt) ' of shirt)

One set must comprise at least 80% single colour per piece. Goalkeeper shirt must comprise different colour to both primarv and alternate colour of shirt.

Name: f frF. rf'St:1 {I tJ(f fl Date: \$ -\.t ~[~ ~ \., Position: M 'frN ~ fY/?.... Signature: f o.A-

.. .. Note: It IS mandatory for the partrc1pating team to be m proper k1t With correct shirt numbers and colors, fa1hng wh1ch they will be penalized. Also, it is mandatory for a team to b,ring two sets of Socks (to avoid any color clash) . .

~-Dr. R. P. Singh General Secretary

· Uttar Pradesh Hocl<ey

C4oL.D

,~or£.--'- )1-C>"l.).._ HOCKEY INDIA

----~--~--------~E=N~T~R~Y~F~O=R~M=-----------·-------( \COMPETITION: 5th Hockey India Senior Men National Championship 2015 (DivA)

DATE Of' COMPETITION: 16 AP_ril 28 April2015

PLAYERS SIJirt Family Name First Name No. [PRINTED- BLOCK [PRINTED- BLOCK LETTERS Father's Date of Birlh

1 - 32 LETTERS] Name (ddlmmlyyyy)

i-lockey.lndia ID Card · · No ..

TEAM COLOURS

Shirt: (!) (<Jw. ~ ~ .[5 L IJ(£

Shorts: ~...J'/}M(E -

pocks: {3 LA-U( fGoalkeepershirt: RC-1:> I}N~ 'y/J1.-L.W (Must comprise different colour to both primary and alternate colour of shirt)

ALTERNATIVE COLOUHS

Shirt: Sky fl,LUb f3i. ,; Shorts ~~&ME- J1 ~5 ( 0. ~fiN '!~A :1 Socks S L.I+<.J< 5\-\. ~ i. fr/IA. Goalkeeper shirt: .J.k.y /1, Ll/tt;./ }/Itt/~ /Y.tJG ~ ; (Must comprise different colour to bofh' primary and alternat~ cl~~ '

One set ~ust comprise at least 80% single colour per piece. Goalkeeper shirt must comprise differe1at colour to both primary and .alternate colour of shirt.

~P~o~sit~io~n=~~M~~~~~(;~~~~~~~~~~~~·-s_ig~n~at~ur~e:~·-~~~~--c~~=~--~--~·: Note. It IS mandatory for the participatmg team to be m proper kit w1th correct shirt numbers and colors, failing which they will be penalized. Also, it is mandatory for a team to bring two sets of Socks (to avoid any color clash).

5'h 2015- 16-28 2016hockeyindia.org/images/stories/2017/12/5th-hockey-indi… · ·...

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