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NSS Form

The document is a student enrollment form for the National Service Scheme at Gujarat Technological University for the year 2021-2022. It collects information such as the student's name, date of birth, enrollment number, blood group, category, activities of interest, addresses, and contact information. The student agrees to abide by NSS rules and that the university is not responsible for any accidents during activities or travel.

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299 views1 page

NSS Form

The document is a student enrollment form for the National Service Scheme at Gujarat Technological University for the year 2021-2022. It collects information such as the student's name, date of birth, enrollment number, blood group, category, activities of interest, addresses, and contact information. The student agrees to abide by NSS rules and that the university is not responsible for any accidents during activities or travel.

Uploaded by

Engineers world
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Gujarat Technological University, Ahmedabad

National Service Scheme


Student Enrollment Form (Year 2021-22)
(All Information fill up by capital letters)

1. Name & Address of Institute: 2. Institute Code:

3. Name of Student:
(Surname) (First Name) (Second Name)
4. Date of Birth:
Age on 1st July, 2021: ____ Years, ____ Months
5. Enrollment Number:
Branch: Semester:
6. Blood Group:

7. Category: O ST O SC O OBC O OPEN

8. Activities of Interest:

O Health O Adventure O Nature


O Academic O Woman Welfare O Other
O Social Work O Children Welfare
O Youth Welfare O Public Relation
9. Permanent Address:
Village/ Town: Taluka:
District: Pin Code:
10. Local Address:

I hereby agree that I will follow & abide by all rules and regulations of NSS. I am participating in NSS
activities on my own will & risk. I am solely responsible for the any injury or accident (minor/fatal) taken
place during the training camp & journey, university will not responsible for any such incident/accident
taken place.

Signature of Parents Signature of Student


Name: Name:
Occupation: Enrollment No:
Contact No: Contact No:
Student is enrolled on the fact that above information is correct.
Year of Joining in NSS:

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