State:

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NATIONAL SCHOOL GAMES 2024-2025
JABALPUR attested by the
District……………………………. Under the aegis of School Games Federation of India H.M /
Principal with
Certificate of Eligibility Date and Seal

Discipline: ……………………………………………Under…..……Boys
UNDER17 / Girls
1 Name of the Participant (In Block Letters) NAVYA GUPTA

2 Father’s Name (In Block Letters) BHUPENDRA GUPTA

3 Mother’s Name (In Block Letters) PRACHI GUPTA

4 Name of the School (In Block Letters) DELHI PUBLIC SCHOOL,MANDLA ROAD,JABALPUR

5 Institution Full Address PIPARIYAKALA, NEAR TFRI, JABALPUR,

MADHYA PRADESH483001
(In Block Letters)
6 Institution Contact Number (with code if any ) +91 8305022217

7 Last Year Registration No.SGFI Text

8 Date of Birth [ i ] In Fig 2 3 0 6 2 0 1 0

[ ii ] In Words TWENTY THIRED JUNE , TWENTY TEN

9 Aadhar No & PEN No 8938 9679 0632 NA

10 Passport No. (If available) M8690530

11 Discipline
12 Age completed in years Years Months Days
as on 31st December 2024 1 4 0 6 0 7

13 Permanent address with FLAT NO. 104, BLOCK- A, KATARIA THEME PARK, MANDLA ROAD
Phone / Mobile No (In Block Letters) TILHARI, JABALPUR , MP, 482020

14 Admission No. & Year 2364/PREP/15-16, 2015-2016

15 Date of Joining the School MARCH 2015

16 Standard & Section Studying this year CLASS IX SECTION A

17 Standard Studying last year CLASS VIII SECTION C

18 Bank Details of participant Name : NAVYA GUPTA

(If no then mention Mother/Father A/C No.) Name of Bank : INDUSIND BANK
A/C No. : 159425163427
IFSC Code : INDB0002230
19 Personal Identification Marks : 1. Birth mark on right side of the stomuch
2. Mole on right shoulder
20 Signature of the Participant
ELIGIBILITY: 1. Eligibility to participate in U/11 Yrs. Age Group born on or after 1-1-2014 and 3rd to 5th class.
2. Eligibility to participate in U/14 Yrs. Age Group born on or after 1-1-20011 and 6th to 12th class.
3. Eligibility to participate in U/17 Yrs. Age Group born on or after 1-1-2008 and 6th to 12th class.
4. Eligibility to participate in U/19 Yrs. Age Group born on or after 1-1-2006 and 6th to 12th class.
CERTIFICATE: 1.Certified that the above participant is a bonafide student of this institution for the years.
2.Certified that I have personally verified the admission record maintained in the school and found correct.
3.Certificate that it is understood in the event of information furnished above found to be partly or wholly untrue, the above student is liable to be
unqualified for a period of two years in case the student is a member of the participant is liable to be disqualified for a period two years in
case the student is a member of the team the participant is liable to be disqualified as a whole.
NOTE : If we found any information is wrong we have a right to remove his / her name from team at any stage.

Signature of the Signature of the Signature with Seal of the Signature with Seal of the district
Parent Class Teacher / P.E.T / P.D Head of Institution / Principal Organizing Secretory School Games Federation

Signature with Seal of the Signature of the Signature of the Competent Authority
68th Inter District Tournament Coach / Manager of State / UT / Unit / with Seal
Organizing Secretory Post / Desn………………………………

For Office Use Only Name of Invigilator …………………………………………… Sign. Of Invigilator ……………………………………..

Pdf available in Physical Education APP or www.ap-physical-literacy.com RAJESH AGOLA

 BONAFIDE CERTIFICATE

This is to certify that Mr. / Kum ……………………………………………S/O,

NAVYA GUPTA
D/O of
……………………………………………………..who is / was bonafide student of this institution
BHUPENDRAGUPTA

during the years from………………..to…….………studied

2015 -2016 2024-2025 from……….to
PREP ………class and as per
IX

institution records his /her particulars are as follow.

1. Admission No : 2364/PREP/15-16

2. Date of Birth : 23 / 06 / 2010

Date: 3 / 12 / 2024 Signature of the H.M / Principal

With Seal

MARKS SHEET

DELHI PUBLIC SCHOOL, MANDLA ROAD, JABALPUR

Name of the School ____________________________________________________
Mandal ____________________________District____________________________
JABALPUR JABALPUR

Name of the Student: NAVYA GUPTA

Class & Section: VIII, C Roll No: 820 C Admn No: 2364/PREP,15-16

S.No Subject Marks Grade Remarks

1 Telugu NA NA

2 Hindi 98.5 A1

3 English 97.38 A1

4 Mathematics 100 A1

5 General science 96.75 A1

6 Social Studies 100 A1

Total 492.63 A1

Date: 3/ 12/ 2024 Signature of the H.M / Principal

With Seal

RAJESH AGOLA
Pdf available in Physical Education APP or www.ap-physical-literacy.com