MEMBERSHIP OF THE NCC CADETS WELFARE SOCIETY

NOMINATION FORM
SECTION

1. ,Cadet (name in block Letters)EHLEMAVARAPL.YASHIASLWL.. Son/Daughter of

Shri (Name in block letters) B . N . a a p A . . . a student of class K . 0 . . . of

the
(Name of College/School)S..£.R.ANLIS.DEREE.Lo.LLEGn... on my enrolment With
NCC on (Date) 2.ial2.2.. with (Name of the unit) l.&.Ls..E.
apply for membership of the National Cadet Corps Cadets Wefare Society and hereby
subscribe a sum of Rs. 4/- (Rupees Four Only) towards its membership fee.

2. My Father/Mother/Guardian's occupation is.T..EMPLONEK. and the

annual income of my family from all sources is Rs 00,00D.. ...per annum.

3. understand that I shall be entitled to financial assistance as determined by the

Goveming 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
detemined by the Goveming BodyManaging 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

wAROOP A 45 MOTER |4-4-141, PAEtt 30

RANL KA MMAM, 5000

BINDU 28 STSTER |4-67/4, 0PP APGVBB

MOUNIKA nNK LANE,LON IJERLA|
KHAMMAN, 509305
(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 enroled

Date:141b/22
Place yDERCAD (Full Signature of the Cadet)
Date: 4 0-02 SECTION-II
Place: tudesaba d
(Signature of PTO/
Head-of thstitution)
St. Francia Principal
College for Women
SECTIONumpet Hyderabad-16.
am willing to allow
my son/daughter/ward (Name)
to become a member of the RBEEMfANANRORU...AIASU....
National Cadet Corps Cadet Welfare
&conditions and the rules in force of Society under the terms
the Society. I
Section (4). also approve the nomination(s) made in

Date: l- 10-022
Place: 11y deaahnd
(Full Signature of the
Witness Father/Mother/Guardian)
Witness

1. ..
******* * 2. ******* *'**"*
Sigrauesr. Ceshu ur
Tn uenti/Accoun Olcer
T. (Signature)
St.
**** ******

Lrincipal
FranclsCollege for Women
.3..(34T) e/40. GF (') RAD
744 68.
Begumpet, Hyderabad-16.
FyNaName &tAddress or 3. 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/SarpanchVillage 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 HO.