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Appendix ‘A’ (Revised 2013)

FORM I

NATIONAL CADET CORPS

SENIOR DIVISION/WING ENROLMENT FORM (see rules 7 and 11 of NCC act 1948)

ENROLMENT FORM (see rules 7 and 11 of NCC act 1948) 1. Name Name (in (in
1. Name Name (in (in BLOCK BLOCK LETTERS): LETTERS): 2. Nationality Nationality & & Date
1.
Name Name (in (in BLOCK BLOCK
LETTERS): LETTERS):
2.
Nationality Nationality & & Date Date of of Birth: Birth
(DDMMYYYY) (DDMMYYYY):
3.
Father/guardian’s name:
4.
Mother’s name:
5.
Residential Address:
6.
Mobile no.:
7.
Email-id:
8.
Blood group:
9.
Sex:
10.
Nearest Railway station:
11.
Nearest police station:
12.
Educational qualification:
13.
Identification marks:

14.

Have you ever been

 
 

convicted by a criminal court & if so what is the circumstances. What was the sentence? Attach relevant documents

15.

Name of the school/college and stream (Arts/Science/Commerce):

16.

Willing to be enrolled and undergo training under the National Cadet Corps act

1948?

17.

NCC Unit to be enrolled in:

18.

Have you ever been enrolled in NCC earlier? If yes your enrollment no.:

19.

Have you been dismissed from the NCC, the Territorial Army, The Indian Armed Forces? Please provide details

20.

Name of Kin with address. (With relationship). Telephone no. (As applicable

21.

Banker’s details:

1.

Name of the bank

2.

IFSC code

 

4.

Branch

 

3.

Bank a/c of cadet or parent.(attach copy)

22.

Aadhar UID no.:

 

23.

PAN card no (if allotted):

copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of
copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of
copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of
copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of
copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of
copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of
copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of
copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of
copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of
copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of
copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of
copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of
copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of
copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of
copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of
copy) 22. Aadhar UID no.:   23. PAN card no (if allotted): Place: Date: (Signature of

Place:

Date:

(Signature of applicant)

DECLARATION ON ACCEPTANCE OF ENROLMENT

1.

I solemnly declare that the answers I have given to the questions in this form are true and 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 to my ability, attend all the 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, travelling and while on YEP or any other such NCC events like RDC and IDC. I understand that I have no service liability.

Place:

Date:

Signature of applicant

Name:

DECLARATION BY PARENT/GUARDIAN

1.

I solemnly declare that the answers given to the questions 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 enrollment of my son/daughter/ward, I will have no claim on authorities for any compensation in the event of injury or death due to accidents during training camps, courses, travelling and while on YEP or any other such NCC events like RDC and IDC.

Place:

Date:

Signature of parent/guardian

Name:

Note: Rs.15 to be paid by each cadet as CWS subscription at the time of enrolment.

CERTIFICATE

Certified that the applicant and his parent/guardian understand and agree to the conditions of enrollment.

Place:

Date of enrolment:

(Unit seal)

Signature of enrolling officer

TO BE COMPLETED BY MEDICAL OFFICER BEFORE ENROLMENT

I have examined (Name)

on (date)

and consider him/her fit/unfit for the enrolment as a cadet in the National Cadet Corps.

Place:

Date:

Signature

Designation (Medical Officer)

Stamp

TO BE USED FOR EXTENSION OF ENROLMENT

(See rule 13)

A. I agree to extend my enrolment for one year and am willing to fulfill the engagement made.

Place:

Date:

Signature of applicant

Confirmed.

Place:

Date:

Signature of Commanding Officer

B. I agree to extend the enrolment of my son/daughter/ward and am willing to fulfill the engagement made.

Place:

Date:

Signature of the parent/guardian

Confirmed.

Place:

Signature of Head master

Date from which extension starts

NOTE: This form will be retained in the College/school in which the unit is located.

Appendix B

Annexure to Form I

(application for enrolment)

INDENMITY BOND

To,

The President of India

In consideration of my being nominated either by the NCC authorities or at my 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 and Air Force Wing activities, as the case may be) and while travelling (in domestic/international surface, air and water transport) and attending Youth Exchange Programme (YEP) abroad, I undertake and agree that I, nor my executors or administrators or other legal representatives will make any claim against the Government or against NCC authorities including officers, JCOs/NCOs, or their equivalents form 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 person, including injury resulting in death, due to any reasons whatsoever which I may suffer, while or in consequence of my participation in the above activities and I understand that no compensation will be paid by Government or NCC authorities including officers, JCOs/NCOs or their equivalents from Navy and Air Force, or civilian MT drivers in respect of any such loss or injury and I agree as to bind myself, my executors and administrators and other legal representatives to indemnify the Government or NCC authorities including officers, JCOs/NCOs, or their equivalents from Navy and Air Force, civilian MT drivers, or any other person in the service of Government against any claim which may be form any third party against them or any of them arising out of any act of default on my part during or in connection with the said camps, courses, adventure training, travelling 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

Name:

Address:

2.

Signature

Name:

Address:

Place:

Date:

Signature of applicant

Name

No

Unit/Group

Signature of parent/guardian

Name

Address

(NOTE: In case of SD applicant being minor Indemnity Bond applicable to minor is used.)

Appendix to letter No.19952/DGNCC/CWS dated 05 Feb 91 NOMINATION FORM FOR MEMBERSHIP OF NCC CADETS WELFARE SOCIETY (to be retained at NCC GP, HQ)

1)

2)

3)

4)

SECTION-1

I, Cadet (Name in Block letters) Block letters) School/college) enrolment with NCC, on date

apply for membership for NCC Cadets Welfare Society and hereby subscribe a sum of Rs.4/-(Rupees Four only) towards its membership fee.

son/daughter of Shri (Name in of (Name of

on my

student of class

with (Name of Unit)

My Father/Mother/Guardian’s occupation is income of my family from all sources is Rs

and the Annual

I understand that I shall be entitled to financial relief as determined by the Governing Body Managing Committee of the above Society in the event of partial of permanent disablement sustained by me while participating in an organized NCC activity. I 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 practical / permanent disablement will be final and binding on me.

I hereby nominate the following person/persons who will receive finance assistant 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 organized NCC activity

S.no

Name of the nominee/ nominees(in Block letter)

Age

Relationship with the cadet

Permanent address of the nominee

Percent of financial assistant payable

(To be filled by the cadet in his own handwriting)

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 been enrolled

Place:

Date:

Place:

Date:

(Full signature of the cadet)

SECTION-II

(Signature of ANO/Head of Institution)

SECTION-III

I am willing to allow my son/daughter/ward (name) become a member of NCC Cadet Welfare Society under the terms and conditions and rules in the force of society. I also approve of the nomination made in section 1 (4)

to

Place:

 

(Full signature of father/mother/guardian with complete address)

Witness 1:

Witness 2:

 

(Signature)

(Signature)

Full name and address of office

Full name and address of office

Seal of witness

Seal of witness

NOTE: The witness should be either gazette Officer Head of Institution/Associated officer/Sarpanch/Village head.

SECTION-IV

Received sum of Rs.15 (Rupees fifteen only) as one time subscription and enrolled as a member of NCC cadets Welfare Society during the cadetship in the junior / Senior Division/wing

Place:

Date:

(Signature of OC Unit with office seal)

SPECIMEN SIGNATURE FORM

SPECIMEN SIGNATURE FORM No School/college. His/her three specimen signature is as under:- Rank Name of 1.

No

School/college. His/her three specimen signature is as under:-

Rank

Name

of

1.

2.

3.

Signature/stamp of ANO

CO/OC Unit
CO/OC Unit

Signature/stamp of Head of Institution