Form I National Cadet Corps Senior Division/Wing Enrolment Form (See Rules 7 and 11 of NCC Act, 1948)

Appendix ‘A’ (Revised 2013)
FORM I
NATIONAL CADET CORPS
ATTESTED PP
SENIOR DIVISION/WING ENROLMENT FORM
(See Rules 7 and 11 of NCC Act, 1948) SIZE COLOUR
PHOTO
1. Name (IN BLOCK LETTERS)
2. Nationality & Date of Birth

(DD/MM/YYYY)
3. Fathers/Guardian’s Name
4. Mother’s Name
5. Residential Addresss
(Landmark, State, Dist,
Taluka, City/Vill, PIN Code)
6. Mobile No.
7. E-mail ID
8. Blood Group
9. Sex
10. Nearest Railway Station.
11. Nearest Police Station
12. Educational Qualification

& Marks in (%).
13. Identification Marks (at least

two)
2

14. Have you ever been

convicted By a criminal court
& if so in what circumstances
and what was the sentence?
Attach relevant documents.
15. Name of School./College P A R V A T I B A I C H O W G U L E

and Stream (Arts/Science/ C O L L E G E O F A R T S A N D
Commerce) S C I E N C E A U T O N O M O U S
A R T S S C I E N C E
16. Willing to be enrolled and Y N

undergo training under the
National Cadet Corps Act, 1948
17. NCC Unit to be enrolled in 1 G O A B N N C C P A N A J I
18. Have you been enrolled in

NCC earlier if yes, Your Y N
enrolment No.
19. Have you been dismissed

from NCC/the Territorial Army/
the Indian Armed Forces.
Please provide details.
20. Next to Kin with addresss

(with relationship) Telephone
No.(O)/(R) as applicable
21. Bankers detail/IFSC Code
22. Bank Acct No.of

Cadet/Parent.
23. Aadhar /UID No. (if allotted)
24. PAN Card No.(if allotted)
Place : _______________ _____________________

(Signature of the applicant)
Date : ___________________
3

DECLARATION ON ACCEPTANCE OF 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 fulfill the engagement made.
2. I ______________________________________promise that I will honestly and faithfully serve my

country and abide by the Rules & Regulations of the National Cadet Corps that I will, to the best my ability,
attend all parades and camps as may be required by the Commanding Officer from time to time
3. I ______________________________________ further promise that after enrolment, I will have no

claim on authorities for any compensation in the event of injury or death due to accident during training camps,
courses, traveling and while on YEP or any other such NCC events like RDC and IDC. I understand I have no
service liability.
…………………………….…
Place : Signature of the applicant Date:
Date :
DECLARATION BY PARENT/GUARDIAN
1. I solemnly declare that the answers I have given to the question in this form are true and that no part of
them is false and that my son/daughter/ward is willing to fulfill the engagement made.
2. I ______________________________________ promise that after the enrolment my

son/daughter/ward, I will have no claim on authorities for any compensation in the event of injury or death due
to accident during training camps, courses, traveling and while on YEP or any other such NCC events like
RDC and IDC.
…………………………………..
Place Signature parent/Guardian
Date:
CERTIFICATE
1. 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)
4

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 Rule 13)
A. I agree to extend my enrolment for one year and am willing to fulfill the engagement made.
Place : …………………….…………
Date : Signature of applicant
Confirmed
………………………………………
Place : Signature of Commanding Officer
Date :
B. I agree to extend the enrolment of my son/daughter/ward for one year and am willing to fulfill the
engagement made.
……………………………………..
Place : Signature of Parent/Guardian
Date :
Confirmed
……………………………………..
Place : Signature of Headmaster
Date from which extension starts……………………..
Note: This form will be retained in the College/school in which the unit is located.

Form I National Cadet Corps Senior Division/Wing Enrolment Form (See Rules 7 and 11 of NCC Act, 1948)

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Appendix ‘A’ (Revised 2013)

2. Nationality & Date of Birth

10. Nearest Railway Station.

11. Nearest Police Station

12. Educational Qualification

13. Identification Marks (at least

14. Have you ever been

15. Name of School./College P A R V A T I B A I C H O W G U L E

16. Willing to be enrolled and Y N

17. NCC Unit to be enrolled in 1 G O A B N N C C P A N A J I

18. Have you been enrolled in

19. Have you been dismissed

20. Next to Kin with addresss

21. Bankers detail/IFSC Code

22. Bank Acct No.of

23. Aadhar /UID No. (if allotted)

24. PAN Card No.(if allotted)

Place : _______________ _____________________

2. I ______________________________________promise that I will honestly and faithfully serve my

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

2. I ______________________________________ promise that after the enrolment my

TO BE COMPLETED BY MEDICAL OFFICER BEFORE ENROLMENT

I have examined Name) ________________________________ on(date) ___________

TO BE USED FOR EXTENSION OF ENROLMENT

Date from which extension starts……………………..

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Place : _ _______

I have examined Name) ______________________ on(date) _