Enrollment Form
Enrollment Form
4. Mother’s Name
5. Residential Address
(Landmark, State, Distt
Taluka, City/Vill, Pin Code)
PIN Code
6. Mobile No.
7. e-mail id
8. Blood Group
9. Sex
10. Nearest Railway Station
Place……………………………..
Date……………………………… Signature of the applicant
DECLARATION ON ACCEPTANCE OF ENROLMENT
1. I solemnly declare that the answers I have given to the question in this form are true and that no
part of them is false and that I am willing to fulfill the engagement made.
2. I promise that I will honestly and faithfully serve my country and
abide by the Rules & Regulations of the National Cadet Corps that I will, to the best my ability,
attend all parades and camps as may be required by the Commanding Officer from time to time
3. I further promise that after enrolment, I will have no claim on
authorities for any compensation in the event of injury or death due to accident during training
camps, courses, traveling and while on YEP or any other such NCC events like RDC and IDC. I
understand I have no service liability.
Place:
DECLARATION BY PARENT/GUARDIAN
1. I solemnly declare that the answers I have given to the question in this form are true and that no
part of them is false and that my son/daughter/ward is willing to fulfill the engagement made.
2. I further promise that after the enrolment my son/daughter/ward, I will
have no claim on authorities for any compensation in the event of injury or death due to accident
during training camps, courses, traveling and while on YEP or any other such NCC events like
RDC and IDC.
CERTIFICATE
Certified that the applicant and his parent/guardian understand and agree to the conditions of enrolment.
Place:
Date of Enrolment…………………………… Signature of Enrolling Officer
(Unit Seal)
INDENMITY BOND
To,
Signature of Applicant
No……………………………………………………..
Rank & Name………………………………………..
1HP BN BOYS Solan, Grp-- Shimla
In the Presence of
Station:
Date :
MEDICAL CERTIFICATE
Station …………………..………
Dated ……………………..…….. (Sig. of Parent/Guardian)
Name and address
Countersigned Countersigned
(head of the Institution)
(Stamp) (CO Unit)
DROWNING/ACCIDENT CERTIFICATE
I know that there is deep water near the camp site or enroute and area of the water is OUT
I have been explained the cadets regarding the precautions to be taken against drowing
accident and have understood them. I have been told not to go near deep water in the vicinity
Certified that I have explained the orders regarding to be taken against drowning accident and
shown to the Cadets “OUT OF BOND AREAS” The cadet have signed in my presence.
Station……………………………………….
Dated………………………………………… Signature of CO Unit
Certified that the above named Officer/Cadets is on the roll of the College/School and can be spared
for the above trekking/expedition Camp.
Station……………………………………….
Dated……………………………………….. Signature of Principal
Appendix ‘A’ to DG NCC NO. 19952/DG/NCC/CWS Dated 5 feb 91
FOR MEMBERSHIP OF THE NCC CADETS WELFARE OSCIETY
(TO BE RDTAINED AT NCC GROUP HEADQUARTERS)
NOMINATION FORM
SECTION-I
2. My Father/Mother/Guardian’s occupation is. and the annual income of my family from all sources
is Rs ............................................................... per annum.
4.I hereby nominate the following person(S) who will receive financial assistance, as determined
by the Governing Body/Managing Committee of the above Society, which will be final and
binding on the following person(s) in the event of my death while participating in an organised
NCC activity: -
SN Age
Name of Nominee/ Relationship Permanent Percentage
Nominees with the Address of of
(In Block Letters) Cadet the Financial
Nominee Assistance
payable
5. My membership in the Welfare Society and this Nomination Form will be valid only till such time I
remain a cadet in the Division or Wing of the NCC to which i have been enrolled.
Date:……………………
Date:………………………….
SECTION-III
Date:…………………………
Witness Witness
1. ............................................................... 2. ................................................................
(Signature) (Signature)
Full Name & Address or Office Seal of the Witness Full Name & Address or Office Seal of the
Witness
Note: - The witnesses should be either gazetted officer/head of institution /Associated NCC
Officer/Sarpanch/Village Head.
SECTION-IV
Received a sum of Rs. 4/-(Rupees four only) as one time subscription & enrolled as a member of the
National Cadet Corps Welfare Society During the Cadetship in the Junior/Senior Division/Wing.
Date:
SECTION-IV
(To be filled by the NCC unit)