NOMINATION FORM
FOR MEMBERSHIP OF THE NCC CADETS WELFARE SOCIETY
(TO BE RETAINED AT NCC GROUP HEADQUATERS
SECTION-1
1. I, Cadet (Name in block letters) _________________________________ Son/ Daughter of
(Name in block letters) sh. ________________________________a student of class
___________________________ of School/ College _____________________ on my enrolment
with the NCC on (Date) ______________ with (Name of the Unit) 11 (O) Bn NCC, Balangir apply
for membership of National Cadets Corps Welfare Society and hereby subscribe a sum of Rs. 4/-
(Rupees Four Only) towards its membership fee.
2. My Father’s/ Mother/ Guardian’s occupation is _____________________ and annual
income of my family from all sources is Rs ______________________
3. I understand that I shall be entitled to financial relief as determined by the Governing Body/
Managing Committee of the above society in the event of partial or permanent disablement
sustained by me while participating in an originated NCC activity. I hereby accept that the decision
of the Governing Body/Managing Committee with regards to the quantum of relief to be paid to me
in the event of my partial/ permanent disablement will be final and binding on me.
4. I herby nominate the following person/ persons who will receive financial assistance as per
the share indicated and as determined by the governing Body/ Managing Committee of the above
society. Which will be final and binding on the following persons in the event of my death while
participating in and organized NCC activity.
Sl. No Name of Age Relationship Permanent Percentage of
Nominee/ with the address of financial
Nominees (In cadets the nominee assistance
Block Letters) payable
(To be filled by the cadets in own handwriting
5. My membership in the welfare Society and this nomination Form will be valid only till such
time I remain a cadets in the Division or Wing of the NCC to which I have been enrolled
Date:
Station: (Full Signature of Cadet)
SECTION – II
Date:
Station: (Signature of ANO/CTO/Head of Institution)
SECTION-III
I am willing to allow my son/ Daughter Ward Name ________________________ to become
members of the NCC Cadets Welfare Society Under the term & condition and the rules in force of
the society. I also approve of the nomination made in section-I (4).
Date:
Place: (Sign of Father/Mother/ Guardian)
With Complete address
Witness Witness
1. …………………………………. 2……………………………………..
(Signature) (Signature)
Full Name & Address or Full Name & Address or
Office seal of the Witness Office seal of the Witness
Note:- The witnesses should be either gazette officer/head of institution / ANO/ 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 Cadet Corps Welfare society during the cadetship in the junior/ senior division wing.
Date:
Place: (Sign of the OC Unit with office seal)
SECTION-V
(to be filled by the NCC unit)
Date of dispatch of the nomination form to Group HQ …………………………………