3_ANNEXURE-I TO V

ANNEXURE-I
FORM –I
(For representing India in an International Competition in one of the recognized

Games/Sports)
NATIONAL FEDERATION/NATIONAL ASSOCIATION OF ______________________
Certificate to meritorious Sportsmen for employment to WG: 2 and WG: 4 in Non- executive
Cadre in Group C posts
Certified that Shri/Smt/Kumari__________________________ Son/Wife/Daughter of

Shri____________________ and resident of
_______________________________________(Complete address) represented the Country
in the Game/Event of ____________________ in ____________________________
competition/Tournament held at _____________from__________ to___________________
The position obtained by the individual/team in the above said competition/Tournament

was___________
The Certificate is being given on the basis of records available in the office of National
Federation/National Association of _________________.
Place:__________
Date:__________
Signature_______________
Name_________________
Designation_____________
Name of the Federation/
National Association_______
Address_________________
Seal____________________
Note: This certificate will be valid only when signed personally by the Secretary, National
Federation/National Association
ANNEXURE-II
FORM –II
(For representing State in India in a Nation Competition in one of the recognized

Games/Sports)
STATE ASSOCIATION OF ________________IN THE GAME _________ OF__________

Shri____________________ and resident of
___________________________________(Complete address) in the Game/Event of
____________________ in ____________________________ National
competition/Tournament held at _____________from__________ to___________________

was___________
The Certificate is being given on the basis of records available in the office of National
Federation/National Association of _________________.
Place:__________
Date:__________
Signature_______________
Name_________________
Name of the State
Association_______
Address_________________
Seal____________________
Note: This certificate will be valid only when signed personally by the Secretary, State
Association
ANNEXURE-III
FORM –III
(For representing a University in Inter-University Competition in one of the recognized

Games/Sports)
UNIVERSITY OF__________

Shri____________________ and resident of _____________________(Complete address)
Student of ________represented University in the Game/Event of ____________________ in
____________________________ Inter University competition/Tournament held at
_____________from__________ to___________________

was___________
The Certificate is being given on the basis of records available in the office of Dean of Sports
or Officer in overall charge Sports in the University _________________.
Place:__________
Date:__________
Signature_______________
Name_________________
Name of the
University_______
Address_________________
Seal____________________
Note: This certificate will be valid only when signed personally by the Dean /Director or
other Officer in overall charge of Sports in the University of ____________
ANNEXURE-IV
FORM –IV
DIRECTORATE OF PUBLIC INSTRUCTIONS/EDUCATION OF THE STATE OF

______________

Student of ________represented ________State School Team in the Game/Event of
____________________ in the National Games for schools held at
_____________from__________ to___________________

was___________
The Certificate is being given on the basis of records available in the Directorate of Public
Instructions/Education of _________________.
Place:__________
Date:__________
Signature_______________
Name_________________
Address_________________
Seal____________________
Note: This certificate will be valid only when signed personally by the Director or
Additional/Joint or Deputy Director in overall charge of Sports/games/for schools in the
Directorate of Public Instructions/Education of the State.
ANNEXURE-V
FORM –V
(For the awardees in the physical efficiency performance conducted by Ministry of

Education and Social Welfare)
GOVERNMENT OF INDIA/DEPARTMENT OF YOUTH AFFAIRS AND SPORTS

represented the School Team in the Game/Event of ____________________ in the National
competition held at _____________from__________ to___________________
The Certificate is being given on the basis of records available in the Ministry of Education
and Social Welfare.
Place:__________
Date:__________
Signature_______________
Name_________________
Address_________________
Seal____________________
Note: This certificate will be valid only when signed personally by the Secretary or other
officer in overall charge of Physical Efficiency in Ministry of Education and Social Welfare.

3_ANNEXURE-I TO V

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ANNEXURE-I

(For representing India in an International Competition in one of the recognized

NATIONAL FEDERATION/NATIONAL ASSOCIATION OF ______________________

Certified that Shri/Smt/Kumari__________________________ Son/Wife/Daughter of

The position obtained by the individual/team in the above said competition/Tournament

(For representing State in India in a Nation Competition in one of the recognized

STATE ASSOCIATION OF ____________IN THE GAME _ OF______

Certified that Shri/Smt/Kumari__________________________ Son/Wife/Daughter of

The position obtained by the individual/team in the above said competition/Tournament

(For representing a University in Inter-University Competition in one of the recognized

Certified that Shri/Smt/Kumari__________________________ Son/Wife/Daughter of

The position obtained by the individual/team in the above said competition/Tournament

DIRECTORATE OF PUBLIC INSTRUCTIONS/EDUCATION OF THE STATE OF

Certified that Shri/Smt/Kumari__________________________ Son/Wife/Daughter of

The position obtained by the individual/team in the above said competition/Tournament

(For the awardees in the physical efficiency performance conducted by Ministry of

GOVERNMENT OF INDIA/DEPARTMENT OF YOUTH AFFAIRS AND SPORTS

Certified that Shri/Smt/Kumari__________________________ Son/Wife/Daughter of

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