National Service Scheme

Enter Form and Volunteer Information Year 20 - 20

Unit Number:

Date

1) Name:

2) student's full name (Surname First):

3) Address:

4) Date of Birth: 1st july's Brings Age year Month

5) Volunteer Blood Group:

E-mail:
Mobile:

6) Caste (SC, ST, OBC, Open) :

7) Interested in what activity?

Health Service in social organization Youth Activities
Educations Hospital Activity Women Evolution
Childcare Loksampak Survey Other

I am convinced that by joining in NSS, I will follow its policies. During my training I agree to join all the kinds of risks I am involved in.

Father Name:
Designation:

Student Name:
Class: ROll No:

............................................................................................ offce Only ....................................................................................................

Looking at the candidate’s information above, Admission is given in.

NSS Joining in:

NSS Group Code No:

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