nordic and baltic deaf sports federation

MARIUS MINKEVICIUS General Secretary Lithuanian Deaf Sport Federation Sv. Kazimiero str.3 Vilnius LT - 01127 Lithuania Fax +370 5 2615480 E-Mail: lksfa@takas.lt

Preliminary entry: ……….... 20.03.2006 Final entry: …………………. 15.04.2006 Registration by name: …… 20.05.2006 Please!!! We ask you to return this form to the EDSU even if your country is not intending to participate. It ist important for our preparaions! Thank you!

Preliminary entry

For the participation in the

NBDSF Championship of basketball From 1^st to 4^th June 2006 in Vilnius/LTU

We will participate in the NBSDF championship of basketball:

WOMEN TEAM: YES r NO r

MEN TEAM: YES r NO r

Name of the organisation: ______________________________________________

Adress ______________________________________________

______________________________________________

E-Mail: ______________________________________________

Telefax: ______________________________________________

_____________________ ____________________ ______________

Place, date President Secretary