10. 1" 12, 18. SENIOR DIVISIONNWING E! Name (IN BLOCK LETTERS) Nationality & Date of Birth (ODIMMIYYYY) Father's/Guardian's Name Mother's Name Residential Address (Landmark, State, Distt Taluka,City/Vill, Pin Code) Mobile No. e-mail id Blood Group Sex Nearest Railway Station Nearest Police Station Educational qualifications & Marks in (%) FORM NATIONAL CADET CORPS MENT FOR} ATTESTED PP Size COLOR Act. 1988 PHOTO Scanned with CamScanner@ > 14, Have you ever been convicted by a criminal ‘court & ifso in what circumstances and what was the sentence? Attach relevant documents, 15, Name of SchoolCollege and Stream (Arts/Science! Commerce) 16. Willing to be enrolled and undergo training © [Y ] [Nv Under the National Cadet Corps Act, 1948 17, NCC Unit to be enrolled in 18. Have you been enrolled in NCC earlier. If yes, Your Enrolment No. YY) 19. Have you been dismissed from NCCithe Territorial Army/the Indian Armed Forces; Please Provide details 20. Next of Kinwith address (with relationship) Telephone No. (OV(R) (as applicable) 21. Bankers detailFSC Code : 22. Bank Acct No of Cadet/Parent 23. Aadhaar/UID No. (If allotted) 24. PAN Card No. (allotted) Place: Date = (Signature of the applicant) Scanned with CamScanner‘ (3) DECLARATION ON ACCEPTANCE FOR ENROLMENT DECLARATION ON ACCEPTANCE FOR ENROL 4. solemnly dectare that the answers | have given to the question in this form are true and that no part of them false, and that | am willing to fulfil the engagement made. 2.1 . promise that I will honestly and faithfully serve my country and abide by the Rules @ Regulations of the National Cadet Corps that | will, to the best of my ability, attend all parades and camps as may be required by the Commanding Officer from time to time. BL esse ; _ further promise that after enrolment, | 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. “Signature if the Applicant Place : Date : DECLARATION BY PARENT / GUARDIAN 4. | solemnly declare that the answers given in this form are true and that no part of them is false, and that my Son/daughter is wiling to fulfil the engagement made. Qh promise that after the enrolment, my son/daughter/ward, | will have claim on authorities for any compensation in the event of any injury or death due to accident uring training camps, courses, traveling and while on YEP or any ather such NCC events lke RDC and IDC. 3, |understand , my son/daughter/ward has no service liability. @ Place : (Signature of ParentiGuardian) Date : CERTIFIATE 4. Certified that the applicant understands and agrees to the conditions of enrolment. 2. Cenied that the applicant and his parent/guardian understand and agrees to the condition of enrolment. @ Place : Date of Enrolment ... (Unit Seal) oe 7 ea ‘For minors only. Score out inapplicable portion’ (Signature of Enrolling Officer) pe Scanned with CamScanner(4) “ TO BE COMPLETED BY MEDICAL OFFICER BEFORE ENROLMENT ' have examined (Name) on ssisss+s(date) and consider him/her Fit / Unfit for enrolment as a cadet in the National Cadet Corps. @ Signature... Place : Designation ........ Date : (Medical Officer) TO BE USED FOR EXTENSION OF ENROLMENT (See Rule 13) My son/daughter/ward agrees to extend the enrolment for one year and | am willing to fulfil the engagement made. Place : (Signature of ParenvGt Date : Confirmed Place : Date : Date from which extension starts... (Signature of Headmaster/Ptincipal) Note : This form will be retained in the school in which the unit is located. Note : @ These are not included in the Form Il of NCC Act & Rules. Scanned with CamScanner, (5) APPENDIX ‘D' ay Annexure to Form I INDEMNITY BOND (Application for enrolment) FOR MINOR APPLICANTS ONLY FOR MINOR APPLICANTS ON To The President of India In consideration of my ward No. see, Name vevvsseeenBOiNg nominate either by the NCC authorities or at his own request as a participant in any NCC Camp (Which includes Republic Day Camp and Independence Day Camp in Delhi), Course, Adventure Training (including Army, Navy & Air Wing activities, as the case may be) and while traveling (in domestic/intemational surface, air and water transport) and attending Youth Exchange Programs abroad, | undertake and agree that neither I, nor my other legal representative will make any claim against the Government, or against NCC authorities including Officer, JCO'sINCO’s or their equivalents from Navy and Air Force, Civilians, MT drivers or against any other such person in the service of the Government, in respect of any loss or injury- to the property or person, including injury resulting in death, due to any reasons whatsoever which my ward may suffer, while or in consequence of his participation in the above activities and | understand that no compensation will be paid by the Government or NCC authorities including Officers, JCO's/NCO’s or equivalents from Navy and Air Force of Civilian MT Drivers in respect of any such loss or injury and | agree as to bind my self my executors and administrators and other legal representatives to indemnify the Government or NCC authorities including Officers, JCO's/NCO's or equivalents from Navy and Air Force, Civilian MT drivers or any person in the service of Government against any claim which may be from any third party against them or any of them arising out of any act of default on his part during or in connection with the said camps. courses, adventure training traveling and while on Youth Exchange Programme or any other such NCC activities as may be organized from time to time within or outside the Union of India. Witness 1, Signature ... Signature of Parent/Guardian Name ... Address .. Name... Address .. 2. Signature.. Name Address .... Place Date : Scanned with CamScanner(Revised) ‘Appendix ‘B' (Refers to para 3 of DG NCC letter No. 19952/DGNCC/CWS Dated. 28 April 2000 * and No. 10056/5/DGNCC/Rajaya Bhasha Dated 09 Sep. 2002) NOMINATION FORM FOR MEMBERSHIP OF THE NCC CADETS WELFARE SOCIETY (TO BE RETAINED AT NCC GROUP HEADQUARTERS) SECTION -1 1. 1 Cadet (Name in block letters) son/daughter of Sh. (Name in block letters).. a student Of Class ............s.ces008 of (Name of College/School).. on my enrolment with the NCC on (Date) .... with (Name of the Unit) 7 seseeeeeseteetese apply for membership of the National Cadet Corps, Welfare Society and hereby subscribe a only) towards its sum of Rs... .. (Rupees. membership fee. 2. _ My Father/Mother/Guardian’s occupation is.. and the annual income of my family from all sources is R per annum. 3. | understand that | shall be entitled to financial relief as determined by the Governing Body / Managing Committee of the above society in the event of partial or permanent disablement sustained by me whole participating in an organized NCC activity. | hereby accept that the decision of the Governing Body / Managing Committee with regard to the quantum of relief to be paid to me in the event of my partial or permanent disablement will be final and binding on me. 4, Thereby nominate the following person / persons who will receive financial assistance as per the share indicated and 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. Si. | Name of the Nominee/ | Age| Relationship with | Permanent _ | Percentage of No. Nominees the cadet Address of the financial (in block letters) Nominee assistance payable T 2. 3. (To be filled by the cadet in own hand writing) 5. My membership in the welfare Society and this Nomination Form will be valid only till such time. | remain a cadet in the Division or Wing of the NCC to which | have been enrolled. Date Place 2 (Full Signature of the cadet) P.T.O. Scanned with CamScannerSECTION -I1 Date Place : (Sig. of ANO/Head of Institution) SECTION - III 'am willing to allow my son/daughteriward name ........ atone sas eset become a member of the NCC Cadets Welfare Society Under the terms and conditions and rules, in force of the Society. | also approve of the nomination made in Section-l (4) (Full Sign. of the Father/Mother/Guardian) with Complete address Date Place_: Witness Witness 1 - 1 eeecosessnvansesseeeeee 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/ANO Sarpanch/Village Head SECTION - IV Received a sum of Rs... cesceeeee(RUDEES «0. . ...only)as one time subscription and enrolled as a member of the NCC Cadets Welfare Society during the cadetship in the Junior/Senior Division/Wing. (Sign. of the OC Unit with office seal) Date Place SECTION-V To be filled in by the NCC Unit Date of dispatch of the Nomination Form to the Group HQ .. Scanned with CamScanner