Appx `A` (Revised 2013)

FORM I
NATIONAL CADET CORPS
Senior Division/ Wing Enrolment Form(See Rules 7 and 11 of NCC Act,1948)

1. Name (In BLOCK LETTERS) :………………………………

………………………………

2. Nationality & Date of Birth :………………………………

(DD/MM/YYYY) ………………………………

3. Father`s / Guardian`s Name :……………………………………………

4. Mother`s Name :. ………………………………………….

5. Residential Address :……………………………………………

(Landmark,State,Distt …………………………………………….
Taluka,City/Vill.Pin Code) …………………………………………….

6. Mobile No. :……………………………………………

7. e-mail id :…………………………………………….

8. Blood Group :…………………………………………….

9. Sex :……………………………………………..

10. Nearest Railway Station :……………………………………………

11. Neartest Police Station :……………………………………………

12. Educational Qualifications :……………………………………………

& Marks in (%)

13. Identification Marks(At least two) :………………..…………………………

……………………………………………

14. Have you ever been convicted by a criminal :……………………………………………

Court & if so in What circumstances and …………………………………………….
What was the sentence? Attach relevant
documents

15. Name of 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 :……………………………………………

Contd..2

(2)
18. Have you been enrolled in NCC earlier :……………………………………………
If yes, your Enrolment No. …………………………………………….

19. Have you been dismissed from NCC/the :……………………………………………

Territorial Army/the Indian Armed …………………………………………….
Forces: Please provide details ……………………………….……………

20. Next of kin with address(with relationship) :……………………………………………

Telephone No.(O)/(R) (as applicable) …………………………………………….
..…….………..…………………………...

21. Banker`s details / IFSC Code :. ………………………………………….

22. Bank Acct No. of Cadet / Parent :……………………………………………

…..…..………………………………….…

23. Aadhaar / UID No. (If allotted) :……………………………………………

24. PAN Card No. (If allotted) :……………………………………………

Place :
……………………………………………….
Date : SIGNATURE OF THE APPLICANT
 DECLARATION ON ACCEPTANCE FOR ENROLMENT

1. I solemnly declare that the answers I have given to the questions 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 of 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 enrollment, 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 : ……………………………………………..
Signature of the applicant
Date :

Contd..3

DECLARATION BY PARENT/GUARDIAN

1. I solemnly declare that the answers given 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-____________________________ ___ Promise that after the enrolment of my

Son/daughter/Ward, I will have to claim on authorities for any compensation in the event of
any 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.

3. I understand my son/daughter/ward has no liability.

Place : …………………………………………….
Date : (Signature of Parent/Guardian)
 CERTIFICATE

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

……………………………….
(Signature of Enrolling Officer)

Place :

Date of Enrolment…………………
(Unit Seal)

Contd..4

TO BE COMPLETED BY MEDICAL OFFICER BEFORE ENROLMENT

1. I , have examined ( Name )………………………………………………………..on

……………………………(date) and consider him/her fit/ unfit for enrolment as a cadet in

National Cadet Corps.

@
Place : Signature………………………….
Designation……………………….
Date : (Medical Officer)
 TO BE USED FOR EXTENSION OF ENROLMENT
(See Rules 13)

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

Place : ………………………………….
Signature of the applicant
Date :

Place :
Date : ………………………………….
Signature of Commanding Officer

B. I agree to extend the enrolment of my son/daughter/ward for one year and am willing

to fulfill the engagement made.

@
Place :

Date : ………………………………………….
Signature of Parent/Guardian
 Appendix ‘A’ to DG NCC No.19952/DG NCC/CWS dated 5 Feb 91.
FOR MEMBERSHIP OF THE NCC CADETS WEKFARE SOCIETY
(To be retained at NCC Group Headquarters)

NOMINATION FORM
SECTION -1

1. I, Cadet (Name in block letters)………………………………………. Son/Daughter of

Shri (Name in Block Letters )……………………………….a student of class………………..
Of (Name of College/School……………………………………………….….on my enrolment
With the NCC on ( Date)…………………………..with (Name of the unit)…………………..
apply for membership of the National Cadets Corps Cadets Welfare Society and hereby
subscribe a sum of Rs.10/- (Rupees four only) towards its membership fee.
2. My Father/Mother/Guardians occupation is ………………………. and the Annual
Income of my family from all sources is Rs……………………. per annum.
3. I understand that I shall be entitled to financial assistance as determined by the Govern-
ing Body/Managing Committee of the above Society to the event of partial or 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 assistance to be paid to me in the event of permanent/partial disablement will
be final and binding on me.
4. I hereby nominated 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 persons (s) in the event of my death, while participating in
the event of my death, while participating in an organized NCC activity :-
Srl. Name of the Nominee/ Age Relationship Permanent percentage of
No nominees with the address of the financial assis-
(in block letter) cadet Nominee tance 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 have been
Enrolled.

Date :
(Full Signature of the Cadet)
Place :

Contd..2
 (2)
SECTION-II

Date : (Signature of PTO/Head of Institution)

Place :

SECTION –III
I am willing to allow my son/daughter/ward Name …………………………………to
Become a member of the National Cadet Corps Cadet Welfare society under the terms and
Conditions and the Rules in force of the society. I also approve the nomination (s) made
In section 1 (4).

Date (Full signature of the father/Mother/Guardian):

With complete address
Place :

Witness Witness

1……………………………………. 2…………………………………………………….
(Signature) (Signature)

Full Name and address or Office seal Full Name and address or Office seal
of the witness of the witness

Note- The witness should be either Gazetted Officer/Head of Institution/Associated NCC

Officer/Sarpanch/Village Head.

SECTION –IV
Received a sum of Rs.10/- (Rupees Ten only) as one time subscription and enrolled as
A member of the National Cadet Crops Welfare society during the cadetship in the Junior/
Senior Division/ Wing.

Date : (Signature of the OC Unit and with Office seal)

Place :

SECTION- V

(To be filled in by the NCC unit)

Date of dispatch of the Nomination form to Group HQ………………………………………

 ADDITIONAL INFORMATION

Name: ______________________________________________

Father Name: ________________________________________

D.O.B_______________________________________________

College Roll No/ University No: _______________________________________

Class Section: _______________________Semester:_________________________

College/Course (Mark Your College and Branch):-

1. Chandigarh College of Engineering (CEC)

 B.Tech(CSE) ( )
 B.Tech(IT) ( )
 B.Tech(ECE) ( )
 B.Tech(ME) ( )

2. CGC College of Engineering (CGC-COE)

 B.Tech(CSE) ( )
 B.Tech(ECE) ( )
 B.Tech(ME) ( )

3. Chandigarh Business School of Administration (CBSA)

 BBA ( )
 BCA ( )
 B.Com ( )

4. Chandigarh College of Hotel Management & Catering Technology (CCHM&CT)

 BHMCT ( )
 B.Sc Airline ( )
 B.sc Hotel Management ( )

5. Chandigarh College of PHARMACY (CCP)

 B.Pharmacy ( )

6. Chandigarh College of TECHNOLOGY (CCT)

 B.sc Biotechnology ( )

Mobile No (Personal) ______________________________________________

Parent’s Mobile :-( F) ______________________ (M) ______________________

Permanent Address________________________________________________

________________________________________________________________

Hostel Address____________________________________________________

Email ID: _________________________________________________________

Adharcard No: ____________________________________________________

 10th Percentage (_________________) 12th Percentage (________________)

Bank Details
Bank Account Number_____________________________________________

Bank Branch____________________________________________________

Bank Branch IFSC Code____________________________________________

Attached Following Document (Mark the attached document):-

th
10 Mark Sheet (_______)

12th Mark sheet or Result copy (_______)

Two Passport size photograph (_______)

Additional activities for which you have received participation certificate or Award

 Dancing ( ) Singing ( ) Athletic ( ) NCC ( ) NSS ( )

Martial Arts ( ) Sports Activity ( )

Any other:-____________________________________________________________________________
_____________________________________________________________________________