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Anubhavi Gaur

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141 views1 page

Anubhavi Gaur

Uploaded by

ommishrastrivesphere
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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STATE/UT/UNIT – VIDYA BHARTI

68th NATIONAL SCHOOL GAMES 2024-25


Under The aegis of School Games Federation of India
Certificate of Eligibility
Under - ….. Boys/Girls

1. Name of participant ANUBHAVI GAUR


(in block letters)
2. Father’s Name (In Block Letters) HARSHWARDHAN
3. Mother’s Name (In Block Letters) MAMTA
4. Name of the School JUGAL DEVI SARASWATI VIDYA MANDIR
(In Block Letters)
5. Fill Address of School DEEN DAYAL NAGAR KANPUR
(In Block Letters)
6. School Phone No. with U-DISE Code No. 05122580667 / 09341201422
7. Last Year Registration No. S.G.F.I.
8. Date Of Birth (1) In Fig 5/11/2010
(2) In Words FIVE NOVEMBER TWO THOUSAND TEN
9. Discipline/Game Name JUDO
10. Passport No. (If Available)
11. Age In Completed Years As On 31 December YEAR 14 MONTH 1 DAYS 26
12. Home Address In Full & Phone No./Mob. No. 3-A/171- AZAD NAGAR KANPUR / 8948715363
13. Aadhar Card No. 918980965818
14. Admission No. & Year 9458/2022
15. Date Of Joining in The School/Admission 30/03/2022
16. Standard & Section Studying In This Year 8 (B)
17. Standard Studying At Last Year 7 (B)
18. Bank Details Of Participate (If Then Mention Name -
Mother/Father A/C No.) Name of bank -
A/c -
IFSC code -
19. Personal Identification Marks
20. Signature Of the Participant
Certificate:-
1. Certified that the above participant is a bonafide student of this institution for the academic year.
2. Certified that the above participant is a bonafide student of this institution for the academic year. Certified that i
have personally verified the admission records maintained in the school and found correct.
3. Certificate that it is understood in the event of information furnished above found to be party of wholly untrue,
the above students is liable to be disqualified for a period of two years in case the member of the team, then the
participant is liable to be disqualified as a whole.

Signature of Component Signature with seal Signature with seal Signature with Seal

The head of
Manager/Coach D.E.O. institute/with Principal/
Authority of
Head Master
State/UT/UNIT Seal

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