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(ANNEXURE-III )
UNIVERSITY COLLEGE, KURUKSHETRA
National Service Scheme (N S S)
Session 2014-15
Note : WRITE ALL THE PARTICULARS IN CAPITAL LETTERS
If you are willing to participate in NSS selflessly then submit this NSS joining form duly filled and signed
in the NSS office latest by 18-08-2012.
1. Name
2. Father’s Name __________________________________________________
3. Mother’s Name ___________________________________________________
4. Date of Birth ________________________________________________
Récent
Photograph
(To be pasted)
5. Class__________________ Roll No.__________6. Category_______________
( Gen. /Res. /SC / BC)
7. University Regn. No. ______________________________________________
8. Are you willing to donate blood If yes, mention blood group ____________________________________
9. Special Hobbies _____________________________________________________________________
10. Social Activities _____________________________________________________________________
11. Hostel Address _____________________________________________________________________
with Phone No.
____________________________________________________________________
13. Correspondence Address _______________________________________________________________
with Phone No.
________________________________________________________________
14. Email Id
_________________________________________________________________
I declare that the above information is correct. I shall also abide by all the rules and shall participate in
N.S.S. activities selflessly.
Dated _____________________
……..…………………………………………………..
Recommendation of the Programme Officer N.S. S.
---------------------------------
Signature of the Volunteer
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