Goa University

ELIGIBILITY PROFORMA FOR NATIONAL UNIVERSITY GAMES

Name of the Tournament: Football Section: Women Name of the Manager: Mr. Osvaldo Da Costa Name of the Coach:Mrs Girijadevi Desai. Name of the Host University: ITM University,
Gwalior Zone West Zone Inter Zonal Yes/No Name of the Participating Goa University.

YEAR 2018-19

S. Name of Sportsperson Father’s Date of College in which Date & Year of Present Name of Duration Date & Year of Number of years Remark
No Name Birth studying Passing Qualifying Class the of Course First Admission of previous
Examination for First Present to participation
Admission to College/ Course while pursuing
University
Name of Date & Year Univ Present Graduate P.G.
Exam Course Course Course
01 Alisha Tavares Salvador 12/12/1997 Carmel College HSSC Mar 2016 TYBcom BCOM 3yrs. June 16 June18 02 --
02 Linda Calado Necessidade 06/12/1997 Carmel College HSSC Mar 2016 TYBcom BCOM 3yrs June16 June18 02 --
03 Velanie Fernandes Xavier 09/04/1998 Carmel College HSSC Mar 2016 TYBA BA 3yrs June16 June18 02 --
04 Avia Jean Vas Filipe 13/06/1999 Carmel College HSSC Mar 2017 TYBcom BCOM 3yrs June17 June18 01 --
05 Kumar Dishna Dilip Dilip 23/07/2000 Carmel College HSSC Mar 2018 FYBA BA 3yrs June18 June18 00 --
06 Patil Akshata Krishna Krishna 05/08/2000 Carmel College HSSC Mar 2018 FYBSc BSc 3yrs June18 June18 00 --
07 Vilma Faleiro Pedro 27/12/1997 Rosary College HSSC Mar 2016 TYBcom BCOM 3yrs June16 June18 01 --
08 Marlet Cardozo Francisco 04/07/1998 Rosary College HSSC Mar 2017 SYBA BA 3yrs June17 June18 01 --
09 Nevilla Colaco Niclao 26/10/1997 Rosary College HSSC Mar 2017 SYBA BA 3yrs June17 June18 01 --
10 Barretto Ancella Maria Aniceto 07/01/2000 Rosary College HSSC Mar 2018 FYBCA BCA 3yrs June18 June18 00 --
11 Da Costa Annette Tereza Osvaldo 27/08/1998 Rosary College HSSC Mar 2017 SYBA BA 3yrs June17 June18 00 --
Gracias Flor
12 Fernandes Anline Sharmila Antonio 22/02/1999 Rosary College HSSC Mar 2017 SYBcom Bcom 3yrs June17 June18 00 --
13 Colaco Jeromina Rosario 06/10/2000 Rosary College HSSC Mar 2018 FYBcom Bcom 3yrs June18 June18 00 --
14 Chetna Tirodker Mahesh 14/11/1997 Don Bosco Panjim HSSC Mar 2015 FYBPed BPed 2yrs June15 June18 03 --
15 Gadekar Rima Harischandra Harischandra 18/11/1996 Don Bosco Panjim HSSC Mar 2015 FYBPed BPed 2yrs June15 June18 01 --
16 Vaz Ansiva Alegre 26/01/1997 Don Bosco Panjim HSSC Mar 2015 FYBPed BPed 2yrs June15 June18 02 --
17 Scindia Saundatikar Veganand 24/07/1999 St. Xaviers College HSSC Mar 2017 SYBBA BBA 3yrs June17 June18 02 --
18 Noronha Rhea Sebastiao 05/08/1998 St. Xaviers College HSSC Mar 2016 TYBA BA 3yrs. June 16 June18 01 --
19 Pereira Riza Duarte 04/12/1997 Govt College Quepem HSSC Mar 2016 TYBcom Bcom 3yrs. June 16 June18 01 --
20 Cynthia Diana Lobo John 05/05/1998 St. Xaviers College HSSC Mar 2014 TYBA BA 3yrs June14 June18 02 --

Certified that the above particulars are correct and true as per records of the University.

MIGRATION CASES: Certified that Sportsperson(s) listed at S.No.(s) NIL above is/are migration cases. He/she/they has/have been admitted to the University.
__________________________ duly enrolled student(s) for ____________________ University courses/class of not less than one academic year’s duration for which
examinations are also conducted by the University. ___________________Seal of the University ___________________________ Signature of the Registrar/Secretary, Sports
Committee ______________
 ADDITIONAL INFORMATION TO BE SUBMITTED FOR CHANGE IN COURSE/FACULTY

S.No. Name of the Father’s Name of Name Name of previous Name of new Date & year of Date & Year of Minimum Remarks
player name previous of new course/faculty course/faculty joining changing to new academic
class class previous course/faculty qualifications of
course/faculty admission to new
course/faculty
a.
b.
c.
d.

Certified that the above particulars are correct and rue as per records of the University.

Further certified that no member of the team listed in this proforma has violated the following rule:
No player, who chose to play on behalf of the State team, in any tournament, without prior permission of the concerned university and in case of tournaments in which
Indian Universities teams are also participating, without prior permission of the Association of Indian Universities, shall be allowed to participate in any university,
inter-collegiate and inter-University tournaments. It was for the concerned university to take appropriate disciplinary action against players playing on behalf of State
teams without their permission as referred to in the preceding sentence.

Date _______________ Seal of the University _____________________ Signature of the Registrar/Secretary, Sports Committee _____________

IMPORTANT NOTE:

1. Only those universities shall be allowed to participate in this tournament which submit this proforma in quadruplicate complete in all respects to the
Organising Secretary in time as required under the rules. Before submitting the team to participate in this tournament, the Organising Secretary shall ensure
that:
(i) Eligibility details as contained herein are neatly typed on this form and do not bear any unauthorized over writings.
(ii) The identity cards bear the photographs of the members of the team and their signatures are duly attested by the concerned Registrar/Secretary, Sports
Committee/Director of Physical Education under seal and the identity cards do not bear any unauthorized over-writings.
(iii) The eligibility details given herein have been thoroughly scrutinized and the Organising Secretary is satisfied that the members of the team are eligible to
participate in the tournament.
(iv) The university has submitted a declaration to the effect that they are not in arrears in respect of the current Annual Subscription or any other dues
payable to the AIU.
2. One copy of the proforma, out of the 4 received by the Zonal Organising University shall be returned to the qualifying university by the Organising Secretary of
the corresponding Zonal tournament, for submission to the Organising Secretary of the Iner-Zonals.
3. Immediately at the end of the tournament the Organising Secretary shall send to the Office of the AIU two copies of this proforma complete in all respect,
4. The following columns must be completed by the Organising Secretary:
i. Date of receipt of this proforma by the Organising Secretary ________________________
ii. Date of the first mach in the tournament of this University _________________________
5. The Organizing Secretary will sign the following certificate before allowing the team to participate in the tournament.
6. Certified that I have checked the eligibility particulars of the members of the team given herein and found them eligible.

Date _____________________ Signature of the IN-Charge Sports Section.