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Appln For Enrolment

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NATIONAL SERVICE SCHEME

APPLICATION FOR ENROLMENT

Name Of School: ……………………………………………………………………………..

1. Name of student : ………………………………………………………


( In block letters )
2. Class : ………………………………………………………

3. Date of birth : ………………………………………………………

4. Sex : Male ( ) Female ( )

5. Caste : SC ( ) ST ( ) OBC ( ) GEN ( )

6. Name of guardian : ………………………………………………………

7. Residential address : ………………………………………………………

………………………………………………………

8. Telephone number : ………………………………………………………

9. Blood group : ………………………………………………………

10. Talents (specify ) : ………………………………………………………

11. Area of interest ( specify ) : ………………………………………………………


(environment/Health/ Rural/
Education/reconstruction ete.) ………………………………………………………

DECLARATION

I ………………………………………………….. hereby agree to obey all the rules


and regulations of National Service Scheme and work imbibing the spirit of the scheme.

Place :

Date : Signature of applicant

FOR OFFICE USE ONLY

Date of enrolment :

Enrolment No. :

Remarks if any :
Signature of the Programme Officer.

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