jk”Vªlar rqdMksth egkjkt ukxiwj fo|kihB

¼lasV̭y izksOghalsal ‘kklu f’k{k.k foHkkxkph vf/klwpuk dzekad 513 fnukad 1 vkWx”V 1923 & }kjk LFkkfir o egkjk”V̭ lkoZtfud fo|kihB vf/kfu;e] 2016
lu 2017 pk egkjk”V̭ fo|kihB vf/kfu;e dazekd 6 }kjk lapkyhr fo|kihB½
dzhMk o ‘kkjhfjd f’k{k.k foHkkx
vkj-ch-Mh- y{ehukjk;u ifjlj] jfouxj] vejkorh jksM] ukxiwj
nqj/ouh dzekad 0712&2531696 @ 9850303154, E-mail : departnmu@yahoo.in/sharadsuryawanshi25269@gmail.com
tkod dz- dzh’kkf’kfo@va-egk-Li/kkZ@2022&2023@1112 fnukad 16-12-2022
izfr]
ek- izkpk;Z@foHkkx izeq[k
lapkfyr o layfXur egkfo|ky;s vkf.k inO;qRrj ‘kS{kf.kd foHkkx
jk”Vªlar rqdMksth egkjkt ukxiwj fo|kihB
fo”k; % vkarj egkfo|ky;hu dq’krh ¼iq#”k@efgyk½ vaftD;in Li/kkZ 2022&2023
vkarj egkfo|ky;hu dq’krh ¼iq#”k@efgyk½ vaftD;in Li/ksZps lfoLrj osGki=d [kkyhy izek.ks vkgs-
 Li/kkZ dkyko/kh % 23 vkf.k 24 fMlsacj 2022
 Li/kkZ LFkG % lqHksnkj dzhMkx`g] fo|kihB dzhMk ifjlj] ukxiwj
 [ksGkMawps mifLFkrhph rkjh[k o osG % 23 fMlascj 2022 jksth ldkGh 9-00 oktrk
 Li/kkZ izeq[k % MkW- ‘kjn ck[kMs
lsokny efgyk egkfo|ky;] ukxiwj
Hkzeu/o.kh dza- 8856077870
Email I.D. : badkest@gmail.com

 rka=hd O;oLFkkid MkW- izohu ikVhy

jsuqd egkfo|ky;] ukxiwj
Hkzeu/o.kh dza- 9890903883
Email I.D. : pravinpatil@gmail.com,
s

[ksGkMawuh mifLFkrhps osGh lknj djko;kph dkxni=s

v½ ik=rk ;knh ¼Eligibilty Form½ 2 izrhr
c½ 10O;k oxkZps eqG (Original) izek.ki= vkf.k xq.ki=hdk
d½ 12O;k oxkZps izek.ki= vkf.k xq.ki=hdk
M½ ekxhy mRrhZ.k ifj{ksph xq.ki=hdk
b½ vk/kkj dkMZ
bZ½ egkfo|ky;kps vksG[k i=
m½ gehi=

 oS|fd; izek.ki= vkf.k izos’khdsps izk#i lkscr tkMsysys vkgs-

lapkyd
dzhMk o ’kkjhfjd f’k{k.k foHkkx
izfrfyih %&
01½ MkW- ‘kjn ck[kMs] lsokny efgyk egkfo|ky;] ukxiwj] Li/kkZ izeq[k] vkarj egkfo|ky;hu dq’krh ¼iq#”k@efgyk½
vaftD;in Li/kkZ 2022&23 ;kauh vko’;d dk;Zokgh ?;koh-
02½ ek- izkpk;Z] lsokny efgyk egkfo|ky;] ukxiwj] ;kauk fouarh dh] R;kauh MkW- ‘kjn ck[kMs] ;kaP;k lsok ofjylkBh
miyC/k d#u n;kO;kr-
03½ ek- izkpk;Z] jsuqd egkfo|ky;] ukxiwj] ;kauk fouarh dh] R;kauh MkW- izohu ikVhy] ;kaP;k lsok ofjylkBh miyC/k d#u
n;kO;kr-
03½ ek- lat; pkS/kjh] v/;{k] Li/kkZ dk;Zdze lehrh] 2022&23 ;kauk ekghrhLro vxzs“khr-
04½ ek- v/;{k] fo|kihB la?k fuoM lehrh 2022&23 ;kauk vko’;d dk;ZokghLro vxzs”khr-
05½ loZ lUekuh; lnL;] fo|kihB la?k fuoM lehrh 2022&23 ;kauk vko’;d dk;ZokghLro vxzs”khr-
06½ Jh- lqfuy xkaoMs] ¼,-os-d-½ vakrj egkfo|ky;hu Li/kkZ d{k] dzhMk o ’kkjhfjd f’k{k.k foHkkx] jk"Vªlar rqdMksth
egkjkt ukxiwj fo|kihB] ukxiwj ;kauh vuq"kaxhd dk;Zokgh ?;koh-
07½ Jh- tkosn jsgeku] ¼,-os-d-½ vakrj fo|kihB Li/kkZ d{k] dzhMk o ’kkjhfjd f’k{k.k foHkkx] jk"Vªlar rqdMksth egkjkt
ukxiwj fo|kihB] ukxiwj ;kauh vuq"kaxhd dk;Zokgh ?;koh-
08½ Jh- oSHko ika<js] ¼,-os-d-½ dzhMk o ’kkjhfjd f’k{k.k foHkkx] jk"Vªlar rqdMksth egkjkt ukxiwj fo|kihB]
ukxiwj ;kauh vuq"kaxhd dk;Zokgh ?;koh-
09½ loZ orZekui=kaps lUekuh; dzhMk laiknd ;kauk fouarh dh] R;kauh vkiys yksdfiz; orZeku i=kr Li/ksZph
foLr`r ekfgrh nsowu lgdk;Z djkos-
 DEPARTMENT OF SPORTS &PHYSICAL EDUCATION
izi=&v
RASHTRASANT TUKDOJI MAHARAJ NAGPUR UNIVERSITY NAGPUR
DETAILED ENTRY FORM ( WRESTLING FREE STYLE- MEN ) 2022-2023

NAME OF COLLEGE :--------------------------------------------------------------------------

-: MEN SECTION :-
Sr. Weight Category Name Reserve
01 57 KG.
02 61 KG
03 65 KG
04 70 KG
05 74 KG.
06 79 KG
07 86 KG
08 92 KG
09 97 KG
10 125 KG.

Signature of Office Seal Signature of the Principal

Physical Education Teacher

DEPARTMENT OF SPORTS &PHYSICAL EDUCATION

RASHTRASANT TUKDOJI MAHARAJ NAGPUR UNIVERSITY NAGPUR

DETAILED ENTRY FORM ( WRESTLING GRECO ROMAN- MEN ) 2022-2023

NAME OF COLLEGE :--------------------------------------------------------------------------

-: MEN SECTION :-
Sr. Weight Category Name Reserve
01 55 KG.
02 60 KG
03 63 KG
04 67 KG
05 72 KG
06 77 KG
07 82 KG
08 87 KG.
09 97 KG.
10 130 KG

Signature of Office Seal Signature of the Principal

Physical Education Teacher
 izi=&c
DEPARTMENT OF SPORTS &PHYSICAL EDUCATION
RASHTRASANT TUKDOJI MAHARAJ NAGPUR UNIVERSITY NAGPUR
DETAILED ENTRY FORM ( WRESTLING FREE STYLE WOMEN ) 2022-2023

NAME OF COLLEGE :--------------------------------------------------------------------------

-: WOMEN SECTION :-
Sr. Weight Category Name Reserve
01 50 KG
02 53 KG
03 55 KG
04 57 KG
05 59 KG
06 62 KG
07 65 KG
08 68 KG
09 72 KG
10 76 KG.

Signature of Office Seal Signature of the Principal

Physical Education Teacher

DEPARTMENT OF SPORTS &PHYSICAL EDUCATION

RASHTRASANT TUKDOJI MAHARAJ NAGPUR UNIVERSITY NAGPUR
INTER COLLEGIATE WRESTLING MEN & WOMEN 2022-2023

MEDICAL FORM
I hereby certify that the following Wrestling & Greco Roma Men & Wrestling Women participate
belonging to …………………………………………………………………………………………College
have been examined by me and found that they are physically fit to participate in the Inter Collegiate
Tournament to held on…………………………………………………

Sr. Name Weight Category

01. …………………………………………………… ………………….

02. …………………………………………………… ………………….
03. ……………………………………………………. ………………….
04. ……………………………………………….…… ………………….
05. ……………………………………………….…… ………………….
06. ……………………………………………….…… ………………….
07. ……………………………………………….…… ………………….
08. ………………………………………………. ………………….
09. ………………………………………………. ………………….
10. ………………………………………………. ………………….

Signature of Principal Medical Officer of the College

Stamp & Seal Stamp & Seal

Signature of Phy.Edu. Teacher OFFICE SEAL

 jk”Vªlar rqdMksth egkjkt ukxiwj fo|kihB
¼lasV̭y izksOghalsal ‘kklu f’k{k.k foHkkxkph vf/klwpuk dzekad 513 fnukad 1 vkWx”V 1923 & }kjk LFkkfir o egkjk”V̭ lkoZtfud fo|kihB vf/kfu;e] 2016
lu 2017 pk egkjk”V̭ fo|kihB vf/kfu;e dazekd 6 }kjk lapkyhr fo|kihB½
dzhMk o ‘kkjhfjd f’k{k.k foHkkx
vkj-ch-Mh- y{ehukjk;u ifjlj] jfouxj] vejkorh jksM] ukxiwj
nqj/ouh dzekad 0712&2531696 @ 9850303154, E-mail : departnmu@yahoo.in/sharadsuryawanshi25269@gmail.com

UNDERTAKING

I ----------------------------------------------------------------------------------------- HEREBY UNDERTAKING

THAT I AM VOLUNTARILY PARTICIPATING IN THIS TOURNAMENT AND THAT I AM PHYSICALLY FIT TO
COMPETE IN THIS TOURNAMENT. I MYSELF WILL BE RESPONSIBLE FOR ANY INJURY OR MISHAP
HPPENDED WHILE PARTICIPATING IN THIS TOURNAMENT.

SIGNATURE OF PLAYER……………………………………………………

NAME OF PLAYER…………………………………………………………..

GAME/EVENT………………………………………………………………..

NAME OF COLLEGE………………………………………………………..

CONTACT NO………………………………………………………………..

NOTE : IN CASE ATHLETE IS MINOR COACH/MANAGER/PARENTS OF THE ATHLETE

ARE REQUETED TO GIVE UNDERTAKING. THIS UNDERTAKING IS MANDATORY AND
SHALL BE SUBMITTED TO RASHTRASANT TUKDOIJI MAHARAJ NAGPUR UNIVERSITY
NAGPUR OFFICIALS BEFORE COMMENCEMENT OF TOURNAMENT.