August 2009                                           VOL. C No. 8

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XXIII SNA BIENNIAL CONFERENCE
KOLKATA, WEST BENGAL, OCTOBER 27 to 31, 2009

COMPETITION REGISTRATION FORM

Competition item(s): Please Tick ( v ) as applicable
- On-the-Spot Painting                             { }
- Floor Decoration                                    { }
- Health Education (English/Hindi)               { }
- Recitation/Poetry (English/Hindi)               { }
- Personality Contest (Mr. SNA & Miss. SNA) { }
- Sports: 100m Race                                { } (Male/Female)      Discuss Throw { v } (Male/Female) &
Javeline Throw                                        { } (Male/Female)
- Talent Night                                         { }
Whether Individual or Group Entry _______________________________________
Participant(s) has / have competed at State level: Yes/No. Tick ( ) as applicable)
Name of Individual Participant____________________________________________
Names of Group Participants ______________________________________________
______________________________________________________________________
Name and Address of the SNA Unit:________________________________________
________________________________________________________________
SNA Unit Subscription Fee Paid on ___________________ TNAI Receipt No._______________
Entry Fee: Rs.25/- (Individual entry) ____________ and Rs.50/- (Group entry) _______________
Sent by M.O./ paid in cash. Tick ( v ) as applicable)

Date____________________________ Receipt No._______________________________________

RECOMMENDATION
This is to certify that the above stated competition item(s) has/have been competed at the State level and qualified for entering at the National level competition. The competitor(s) is/are from SNA Unit which has paid subscription for 2009.
__________________                                                          _________________________________
Student(s) Signature                                                     (Seal and Signature of the State SNA Advisor)

RULES OF ENTRY FOR THE COMPETITION
1. All entries must have competed at the State level. Only one entry from each State/UT should be sent for the National competition.

2. In any group item, more than three participants will not be permitted to participate from each State.

3. Entry fee: MO/Cash of Rs.25/- (Individual entry) and Rs.50/- (for group entry). No entry fee for Talent Night items.
4. Last date of receiving the duly filled form is August 30, 2009.

5. One form for each item (group or individual).

6. Completed form(s) (with signature of the State SNA Advisor) alongwith entry fee to be sent to the SNA Advisor, L-17, Florence Nightingale Lane, Green Park, New Delhi – 110016. Entry fee payable to the Trained Nurses’ Association of India.

Note: In any group item each contestant should give his/her name and complete address in the entry form for issuing meritcertificates.

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