Name & Address of the School Address of the Educational District Convener
CATEGORY : Under - _____________ Boys / Girls
With Contact Number With Contact Number
BORN ON OR
CATEGORY STANDARD
AFTER
UNDER 14 6 TH TO 8 TH 01.01.2004
UNDER 17 6 TH TO 10 TH 01.01.2001
UNDER 19 11 & 12
TH TH
01.01.1999
NAME OF THE PLAYER STD &
S.NO EMIS No. DATE OF BIRTH SIGNATURE OF THE STUDENT
(IN BLOCK LETTER) SEC
Certified that the above are the bonafide students of this institution and the particulars furnished above are correct as per the school records.