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Gandhi College, Bengaluru
Affiliated to Bengaluru Central University
NSS ENROLMENT FORM 2019 – 2020
1. Name of the Student and Class :
(In capital letters)
2. Date of Birth and age :
Contact No. & Email Id :
3. Name and address of the Parents :
Contact No. & Email Id :
4. Address during term :
5. Indicate whether you know the general skills
Mentioned in this column:
a) Cycling e) Literary talents
b) Swimming f) Cultural talent
c) Sports g) Any other skill
d) Farming
(Please tick against that you know)
6. Previous experience of NSS (Work done, If any): Yes No
7. Whether you were/are in NCC : Yes No
8. Indicate whether your belong to SC/ST:
9. Blood group of volunteer :
DECLARATION
_____________________ Class _______hereby declare that if I am admitted to NSS. I shall
abide by the rules and discipline of NSS in force, I am aware that I am liable for disciplinary
action which might include expulsion from NSS for non-compliance of the rule that are in
force or any other directive issued by the officers.
SIGNATURE OF THE CANDIDATE
NSS Programme Officer
(With Office Seal)
SIGNATURE OF THE PARENTS