Appendix ‘A’ (Revised 2013)

FORM II
NATIONAL CADET CORPS

SENIOR DIVISION/WING ENROLMENT FORM ATTESTED

PP SIZE
(See Rules 7 and 11of NCC Act, 1948) COLOR PHOTO

1. Name (IN BLOCK

LETTERS)

2. Nationality & Date of

Birth (DD/MM/YYYY)

3. Father’s Name

4. Mother’s Name

5. Permanent Address

6. Mobile/Land Line
Telephone
Number
7. e-mail id

8. Blood Group

9. Sex

10. Nearest Railway

Station

11. Nearest 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.
 -2-

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

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 detail/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 fulfil the engagement
made.

2. I................................................................promise that I will honestly and faithfully

serve my country and abide by the rules and Regulation of the National Cadet
Corps that I will, to the best of my ability.

3. I.......................................further promise that after enrolment, I will have no claim

on authorities for any compensation in the event of injury due to accident during
training camps, courses, travelling and while on YEP or any other such NCC
events like RDC and IGC. I understand I have no service liability.

Place: ..........................................
Date: Signature of Applicant

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/wars is willing to fulfil the
engagement made.

2. I ...................................................promise that after enrolment of my

son/daughter/ward, I will have no claim on authorities for any compensation in the
event of any injury or death due to accident during training camps, courses,
travelling and while on YPE or any other such NCC events like RDC and IGC.

Place: ………….................................
Date: Signature of Parent/Guardian

CERTIFICATE

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

Place ............................................................
Date of Enrolment: Signature of Enrolling Officer
(Unit Seal)
 CERTIFICATE

1. Certified that the applicant understands and agree to the conditions of

enrolment.

*2. Certified that the applicant and his parent/guardian understand and
agree to the conditions of enrolment.

Place: Signature of Enrolling Officer

Date of Enrolment:
(Unit Seal)

* For Minors only. Score out in applicable portion.

TO BE COMPLETED BY MEDICAL OFFICER BEFORE ENROLMENT

I have examined (Name). ................................................................... on

.................................... (Date) and consider him/her fit/unfit for enrolment

as a cadet in the National Cadet Corps.

Place: Signature...................................
Date: Designation................................
(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 fulfil the
engagement made.

Place: …...............................................
Date: Signature of Applicant

Confirmed

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

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

am willing to fulfil the engagement made.

Place: ............................................................
Date: Signature of Parent/Guardian

Confirmed

Place: .................................................
Date from which Extension Starts: Signature of Principal
 APPENDIX ‘B’
Annexure to Form I
(Application for Enrolment)

INDENMITY BOND

To,

The President of India

In consideration of my ward No Name

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 traveling (in domestic/ international surface, air and water
transport) and attending Youth Exchange Programme (YEP) abroad, I undertake and
agree that neither I, nor my executors or administrators or other legal representatives
will make any claim against the Government or against NCC authorities including
officers, JCO’s/ NCO’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 I may suffer, while or in consequence of my participation in
the above activities and I understand that no compensation will be paid by the
Government or NCC authorities including officers, JCO’s/NCO’s 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 equivalent 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 my 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.

Signature of Parent/Guardian
Name
Address
Witness
1. Signature
Name
Address

2. Signature
Name
Address

Place:
Date:
(NOTE: In case of SD applicant being a minor, Indemnity Bond applicable to Minor will be used)
 MEMBERSHIP OF THE NCC CADETS WELFARE SOCIETY
NOMINATION FORM
SECTION-I

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 Cadet Corps Cadets Welfare Society and hereby
subscribe a sum of Rs. 4/- (Rupees Four Only) towards its membership fee.

2. My Father/Mother/Guardian’s 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

Governing Body/Managing committee of the above Society in the event of partial or
permanent disablement sustained by me while participating in an organised NC 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 nominate 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 person(s) in the event of my death while participating in an
organised NCC activity:-

Ser. Name of Age Relationship Permanent Address of the Percentage

No Nominee(s) with the Nominee(s) of Financial
Cadet Assistance
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:

Place: (Full Signature of the Cadet)

 2

SECTION-II
Date:
Place: (Signature of PTO/ Head of Institution)

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
& conditions and the rules in force of the Society. I also approve the nomination(s) made in
Section I (4).

Date:
Place: (Full Signature of the Father/Mother/Guardian)
Witness Witness

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

Full Name & Address or Full Name & Address or

Office Seal of the Witness Office Seal of the Witness

Note: - The witnesses should be either gazetted officer/head of institution /Associated NCC
Officer/Sarpanch/Village Head.

SECTION-IV
Received a sum of Rs. 4/- (Rupees four only) as one time subscription & enrolled as a
member of the National Cadet Corps Welfare Society during the Cadetship in the
Junior/Senior Division/Wing.
Date:
Place: (Signature of the OC Unit with Official Seal)

SECTION-V
(To be filled by the NCC unit)

Date of despatch of the Nomination form to Group HQ ................................................

 SPECIMEN SIGNATURE FORM

PHOTO

No. Rank Name

of School / College.

His/her three specimen signatures are as under :-

Signature / Stamp of ANO Sig / Stamp of Head of Institutions

CO / OC Unit