ENTRY FORM FOR AGARWAL SAMAJ “TIBCON” ANTAKSHIRI 2005
Name of the Team Leader…………………………………………………………….SENIORS/JUNIORS
Address………………………………………………………………………………………………………..
Tel: (O)……………………………….(Res)……………………………..Mobile…………………………….
E mail……………………………………………………Shakha……………………………………………..
Names of other team Members (1)………………………………..(2)………………………………………..
I am enclosing herewith Rs. 300-00 by way of
cash towards entry fee.
Signature of the Team Leader
No.
Received an Entry form for Agarwal Samaj TIBCON
Antakshiri 2005 alongwith entry fee of Rs. 300-00 from
Sri/Smt/……………………………………………………
Authorised Agent
.
No.