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CISCE Sports - Zone-1 2022-2023

Common Entry Form for Team / Individual Events

INDIAN EDUCATION SOCIETY ORION

Name of
RAJA SHIVAJI VIDYASANKUL, HINDU COLONY, KHARE GHAT RAOD, Ward - Football
Name & Address Of The Game
GATE NO.10, DADAR EAST
School / College
Age
Pin Code 400014 Taluka 17
Group
School Tel No. 9137939253 School Email ID orion@ies.edu Gender

School (Boys /Girls)

P. T. Teacher/ Team Manager MA216 Boys

Mobile No. CISCE Code Current DSO
Name
Reg. No.
PLAYER'S DETAILS

Sr.
Date Of Birth
Current Standard

Student Details Gender Player Id GR No. Body Identification

No. (DD/MM/YYYY) 1 to 12

Mark on Right hand Elbow

1 Boy ICSESP2223021229 25-Jan-2008 10 597

None
Name : Aneesh Ashish Bhandari

Father : Ashish Bhandari

Mother : Latika Bhandari

None

2 Boy ICSESP2223021241 03-Dec-2007 10 600

None
Name : Neil Pramod Devkar

Father : Pramod Devkar

Mother : Neha Devkar

None

3 Boy ICSESP2223021247 16-Nov-2009 8 924

None
Name : Rohil Santosh Patil

Father : Santosh Patil

Mother : Kalyani Patil

Wound Scar on Stomach

4 Boy ICSESP2223021256 30-Jul-2007 10 601

None
Name : Sumukh Subhash Nakashe

Father : Subhash Nakashe

Mother : Sneha Nakashe

Right side above lips

5 Boy ICSESP2223021286 06-Jan-2009 9 843

on the stomach
Name : Shiven Rupesh Shetty

Father : Rupesh Shetty

Mother : Veena Shetty

left Hand Thumb

6 Boy ICSESP2223021301 14-Jan-2008 9 1505

Right hand Middle Finger
Name : Deep Bhavesh Rambhiya

Father : Bhavesh Rambhiya

Mother : Nayana Rambhiya

scar above the right eyebrow

7 Boy ICSESP2223021517 11-Mar-2008 10 896

NONE
Name : Jeman Gautam Pendse

Father : Gautam Pendse

Mother : Madhura Umrani



Mole On Forehead

8 Boy ICSESP2223021547 03-Sep-2008 9 900

NONE
Name : Aradhya Girish Sawant

Father : Girish Sawant

Mother : Swati Sawant

on right Ear

9 Boy ICSESP2223025402 23-Oct-2007 10 688

A mole On the left ear
Name : Sidharth Sanjay Kalshyan

Father : Sanjay Kalshyan

Mother : Poonam Kalshyan

NONE

10 Boy ICSESP2223025462 23-Jul-2008 9 781

NONE
Name : Ahaan Dinesh Parkar

Father : Dinesh Parkar

Mother : Asmita Parkar

Male On left Side of Forehead

11 Boy ICSESP2223025471 14-Aug-2007 10 635

None
Name : Meet Shailesh Padwal

Father : Shailesh Padwal

Mother : Amita Padwal

Black Mole Near Right Ear

12 Boy ICSESP2223025480 30-Mar-2008 10 641

Black Mole near Left eye
Name : Anirudh Pramod Nayak

Father : Pramod Nayak

Mother : Shailaja Nayak

Mole On Left Cheek

13 Boy ICSESP2223025669 29-Dec-2007 10 555

Name : Manan Prasad Gore
NONE
Father : Prasad Gore

Mother : Shweta Gore

Mole On right Cheek

14 Boy ICSESP2223025675 07-Mar-2008 10 603

NONE
Name : Samarth Rahul Kolambkar

Father : Rahul Kolambkar

Mother : Dipti Kolamkar

Black Spot On right arm

15 Boy ICSESP2223025687 27-Aug-2007 10 666
NONE
Name : Yash Krishna More

Father : Krishna More

Mother : Krutika More

Mole on the small fingure of left hand

16 Boy ICSESP2223026023 24-Jun-2008 9 850

NONE
Name : Amal Nilesh Mayekar

Father : Nilesh Mayekar

Mother : Apurva Vaidya

Left Leg Shin

17 Boy ICSESP2223026032 12-Oct-2007 10 578

None
Name : Rudraksh Sachin Kadam

Father : Sachin Kadam

Mother : Sonali Kadam



NONE

18 Boy ICSESP2223026362 06-Apr-2009 8 2014

NONE
Name : Mayank Laxmikant Mahendrakar

Father : Laxmikant Mahendrakar

Mother : Manju Mahendrakar

Name & Sign of P. T. Teacher Name & Sign. of Principal
Date School Stamp

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