SECTIONS Pref tia 2000
{ od oh ETE ofS
Date: SO//.2022 ie Cones vers
(Signature of PTO/Head oft
Place:
woo: Cy yh Prot. SM. sri vasta veer
SchOOl OF log Lgovernsheegey cy
SECTION-II seer Re a
| am willing to allow my son/daughter/ward (Name)
to become a member of the National Cadet Corps Cadet Welfare Society under the terms
& conditions and the rules in force of the Society. | also approve the nomination(s) made in
Section | (4).
Date: 50-11-22. PST uTgd
Place: Cy ey A (Full Signature of the Father/Mother/Guardian)
Witness Witness
S
GVA GUPTA
(Signature)
Py, 4 BN.0, NCC
PIOK SP Srivastava, ‘CENTRAL UNIVERSITY OF SCUTH BIHAR, GAYA
School of law & yuvernie, cus
r
Full Name & addr
Full Name & Address or
Office Seal of the Witness
Office Seal ofttt
cs
fer
ae sayri Btat
Note: - The withiéss Béeither gazetted officer/head of institution /Associated NCC
Officer/Sarpanch/Village Head.
SECTION-IV
Received a sum of Rs. 4/- (Rupees four only) as one time subscription & enrolled as a
member of the National Cadist Corps Welfare Society during the Cadetship in the
Junior/Senior DivisionWing.
Date:
Place: (Signature of the OC Unit with Official Seal)
SECTION-V
(To be filled by the NCC unit)
Date of despatch of the Nominat.on form to Group HQ ....
isto"