K. R.

MANGALAM UNIVERSITY, SOHNA

(NATIONAL SERVICE SCHEME)

NSS Volunteers Enrolment Form

Name : Roll Number :

Father’s Name :
PASTE RECENT
Mother’s Name : PASSPORT SIZE
PHOTOGRAPH
Course : D. O. B. :

Category: General/ SC/ ST/ OBC Blood Group :

Residential Address :

Contact Number : Guardian’s Contact No.

Email ID :

OATH
(i) I, hereby declare to abide, adhere & promote the values of NSS.
(ii) I shall devote a minimum of 120 hours for various NSS activity.

Date : (Signature of the

Volunteer)

(For Office Use Only)

Year of Joining NSS:

Unique ID No. :

Note: Registration fees for a Volunteer is Rs. 100/- .

Verified by NSS Officer

NSS Program Coordinator

(Signature )
 NATIONAL SERVICE SCHEME
K. R. Mangalam University, Sohna Road,
Gurugram-122103
Contact No.: 0124-2867800

UNDERTAKING

I, ………………………….. Son/Daughter of ………………………… students of

class/course…………………………at K R Mangalam University, Gurugram undertake to state that, I
shall be attending the NSS- K R Mangalam University for 2 years and will attend the programs conducted
outside and inside the campus during my volunteership at my own risk.

• In consideration of my being nominated at my request to undergo all types of training and also
participating in any NSS training activities in/outside NSS and traveling, I undertake and agree that
neither I nor my parents/gaurdian will make any claim against any officer of NSS/ Program
Officer/Program Coordinator in respect of any loss or injury to the property or person (including injury
resulting in death), which may suffer while or inconsequence of my being in training/participation.
• I, further undertake to state that I shall be abiding by all rules & regulation of the camp and shall be
liable for strict disciplinary action for violation of the same.
• During my volunteership, I will fully cooperate with the incharge and abide by instructions given.
• That I will not include/involve myself in any misbehaviour / indiscipline/ act amounting to indiscipline.

Date: ______________ Signature of the Student

__

Undertaking from the Parent / Guardian

I Father/Mother/Guardian of Mr./
Ms.__________________________________who is a student of____________________Programme in K.
R. Mangalam University, Gurugram hereby declares the following in respect of my ward.

1. I am giving permission to child / ward named above to join as NSS volunteer for 2 years.
2. That my child / ward shall abide by the rules and regulations of NSS-KRMU.

Date: Counter Sign of the Parent/ Guardian

Mobile No:-