GAUTAM BUDDHA UNIVERSITY,

Greater Noida

Application Form for NSS Volunteer

1. Name of the student (in capital):

2. Gender: Photograph of
3. Father’s Name: NSS
Volunteer
4. Mother Name :
5. Date of Birth:
6. Category: General/OBC/SC/ST
7. Course:
8. Department/School:
9. Year of Admission:
10. Enrolment No:
11. Address: Communication Address: Permanent Address:

12. Email:
13. Mobil No:
14: Adhar Card No:
15. Blood Group:
16. Previous experience of NSS (Yes/No):
17. Area of Interest:

Declaration:
I, hereby declare to abide, adhere and promote the values of NSS .

(Signature of the Volunteer)

Forwarded and Recommended

Signature of Head/Dean

(For Office Use Only)

Volunteer No:

Signature of Programme officer Signature of NSS Coordinator