If you need a visa support. Provide this is information to each participant
International Tournament on Pencak Silat
“Open Uzbekistan 2013”
ENTRY BY NAME
COUNTRY / STATE: ____________________________________
| No. | Participant Name | Passport No. | Date of Birth | Sex | Function / Category |
TO BE SUBMITTED LATEST BY 10ST August 2013 TOGETHER WITH 2 PASSPORT SIZE PHOTOGRAPH (pls write name and function behind the photo)
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ENTRY BY NUMBER 17-40
COUNTRY / STATE: ____________________________________
| No. | Function | Category / Function | Entry by Number |
| Team Manager | |||
| Asst. Team Manager | |||
| Coach | |||
| Coach | |||
| Coach | |||
| Extra Official | |||
| Match Male | Class ‘A’ (Above 45 – 50 kg) | ||
| Class ‘B’ (Above 50 – 55 kg) | |||
| Class ‘C’ (Above 55 – 60 kg) | |||
| Class ‘D’ (Above 60 – 65 kg) | |||
| Class ‘E’ (Above 65 – 70 kg) | |||
| Class ‘F’ (Above 70 – 75 kg) | |||
| Class ‘G’ (Above 75 – 80 kg) | |||
| Class ‘H’ (Above 80 – 85 kg) | |||
| Class ‘I’ (Above 85 – 90 kg) | |||
| Class ‘J’ (Above 90 – 95 kg) | |||
| Class ‘OPEN’ (Above 95 kg) | |||
| Male Artistic | ‘Single’ | ||
| Female Match | Class ‘A’ (Above 45 – 50 kg) | ||
| Class ‘B’ (Above 50 – 55 kg) | |||
| Class ‘C’ (Above 55 – 60 kg) | |||
| Class ‘D’ (Above 60 – 65 kg) | |||
| Class ‘E’ (Above 65 – 70 kg) | |||
| Class ‘F’ (Above 70 – 75 kg) | |||
| Class ‘OPEN’ (Above 75 kg) | |||
| Female Artistic | ‘Single’ |
TO BE SUBMITTED LATEST BY 10th August 2013
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ENTRY BY NUMBER 14-17
COUNTRY / STATE: ____________________________________
| No. | Function | Category / Function | Entry by Number |
| Match Male | Class ‘A’ (Above 39 – 42 kg) | ||
| Class ‘B’ (Above 42 – 45 kg) | |||
| Class ‘C’ (Above 45 – 48 kg) | |||
| Class ‘D’ (Above 48 – 51 kg) | |||
| Class ‘E’ (Above 51 – 54 kg) | |||
| Class ‘F’ (Above 54 – 57 kg) | |||
| Class ‘G’ (Above 57 – 60 kg) | |||
| Class ‘H’ (Above 60 – 63 kg) | |||
| Class ‘I’ (Above 63 – 66 kg) | |||
| Class ‘J’ (Above 66 – 69 kg) | |||
| Class ‘K’ (Above 69 – 72 kg) | |||
| Class ‘L’ (Above 72 – 75 kg) | |||
| Class ‘OPEN’ (Above 75 kg) | |||
| Male Artistic | ‘Single’ | ||
| Female Match | Class ‘A’ (Above 39 – 42 kg) | ||
| Class ‘B’ (Above 42 – 45 kg) | |||
| Class ‘C’ (Above 45 – 48 kg) | |||
| Class ‘D’ (Above 48 – 51 kg) | |||
| Class ‘E’ (Above 51 – 54 kg) | |||
| Class ‘F’ (Above 54 – 57 kg) | |||
| Class ‘G’ (Above 57 – 60 kg) | |||
| Class ‘H’ (Above 60 – 63 kg) | |||
| Class ‘I’ (Above 63 – 66 kg) | |||
| Class ‘OPEN’ (Above 66 kg) | |||
| Female Artistic | ‘Single’ |
TO BE SUBMITTED LATEST BY 10th August 2013
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ENTRY BY NUMBER 12-14
COUNTRY / STATE: ____________________________________
| No. | Function | Category / Function | Entry by Number |
| Match Male | Class ‘A’ (Above 28 – 30 kg) | ||
| Class ‘B’ (Above 30 – 32 kg) | |||
| Class ‘C’ (Above 32 – 34 kg) | |||
| Class ‘D’ (Above 34 – 36 kg) | |||
| Class ‘E’ (Above 36 – 38 kg) | |||
| Class ‘F’ (Above 38 – 40 kg) | |||
| Class ‘G’ (Above 40 – 42 kg) | |||
| Class ‘H’ (Above 42 – 44 kg) | |||
| Class ‘I’ (Above 44 – 46 kg) | |||
| Class ‘J’ (Above 46 – 48 kg) | |||
| Class ‘K’ (Above 48 – 50 kg) | |||
| Class ‘L’ (Above 50 – 52 kg) | |||
| Class ‘OPEN’ (Above 52 kg) | |||
| Male Artistic | ‘Single’ | ||
| Female Match | Class ‘A’ (Above 28 – 30 kg) | ||
| Class ‘B’ (Above 30 – 32 kg) | |||
| Class ‘C’ (Above 32 – 34 kg) | |||
| Class ‘D’ (Above 34 – 36 kg) | |||
| Class ‘E’ (Above 36 – 38 kg) | |||
| Class ‘F’ (Above 38 – 40 kg) | |||
| Class ‘G’ (Above 40 – 42 kg) | |||
| Class ‘H’ (Above 42 – 44 kg) | |||
| Class ‘I’ (Above 44 – 46 kg) | |||
| Class ‘OPEN’ (Above 46 kg) | |||
| Female Artistic | ‘Single’ |
TO BE SUBMITTED LATEST BY 10th August 2013
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Contact Address
| Officer’s Name | |
| Contact Address and Telephone / mobile no. | |
| Landline No. | |
| Fax No. | |
| E-Mail address |
VISA SUPPORT:
If you need a visa support. Provide this is information to each participant
Personal information:
Surname: ………………….
F/name: ……………..
Date of birth: …………………
Place of bithr: …………………………
Passport no: ……………………………..
Date of Issue: ………………………………………….
Place of passport issue: ……………………………………..
Expiration date: ……………………………………..
Occupation: ………………………………………..
Place of work: ………………………………………………….
Marital status: …………………………………………………
Nationality: ………………………………………………..
Native language: ……………………………………….
Citizenship ………………………………………
Sex: ………………………………..
Home Address And @-mail: ……………………………………………..
Phone number: ………………………………………………
EXAMPLE:
Personal information:
Surname: Sukhorukova
F/name: Irina
Date of birth: 15.10.1990
Place of bithr: Tashkent city. Uzbekistan
Passport no: CK 2042777
Date of Issue: 15.11.2006
Place of passport issue: Tashkent
Expiration date: 14.10.2013
Occupation: Student
Place of work: The State Institute of Physical Culture. Tashkent city. Uzbekistan
Marital status: single
Nationality: Russian
Native language: Russ
Sitizenship: Uzbekistan
Sex: Female
Home Address And @-mail: House#11, Lisunova#6 Street , Tashkent city. Uzbekistan <tapo-00@mail.ru>
Phone number: (+99894)1772779