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Annex-I
REPUBLIC DAY PARADE CAMP-2013-14
NOMINATION FORM FOR STATE/UT LEVEL SELECTION CAMP
A: PERSONAL DETAILS (in capital letters)
(i)
Name: Mr./Miss_______________________________________________
(ii)
(Surname )
Nomination is for…………..
(First name)
(iii)
Date of birth: ________________________________________________
(iv)
Father’s Name: ______________________________________________
(v)
Mother’s Name: ______________________________________________
(vi)
Educational Qualification: _______________________________________
B: CONTACT DETAILS
(i) Contact Address & Telephone no.
(ii) Permanent Address & Telephone no
( College)
( Residence)
Telephone No(s):
Mobile No(s):
C: NSS UNIT DETAILS
(i) Name & Address of Prog. Officer
Telephone No(s):
Mobile No(s):
E mail ID
(i) Name & Address of Prog. Coordinaor
Telephone No(s):
Mobile No(s):
D: OTHER DETAILS
(i) Height (in cm) ______________
Telephone No(s):
Mobile No(s):
(iii) Food habit: Veg/ Non-Veg____
(iv) Blood Group: __________________
(v) NSS Camps attended:
(vi) NSS Enrollment Year: ___________
(ii) Weight (Kg.) ___________________
(viii) Hobbies:
Signature of the Volunteer & Date
Signature of the Prog. Officer & Date
(SEAL)
ANNEXURE-II
SELECTION CRITERIA OF PRE RD CAMP-2013
As you are aware that the National Service Scheme (NSS) is the flagship programme of the
Department of Youth Affairs under the Ministry of Youth Affairs and Sports
NSS Republic Day Parade Camp is a prestigious national level event. Participation in
Republic Day Camp is a matter of great pride in the life of NSS volunteer. There is a very high
expectation of policy makers from the NSS volunteers in this camp. So it goes without saying that
selection for these camps has to be very serious business. To select the best volunteers, first unit level
selections have to be properly conducted. These guidelines have to be followed strictly by all the
selection committees at various levels to have proper and fair selection.
Eligibility Criteria for Selection of NSS volunteers for Pre R.D. Camps
1.
2.
One institution/college should select maximum one (Male or female) volunteer only. In case
a volunteer is extra ordinary and the College is having more than two units, then two
volunteers may be considered from that institution.
Each nominee must fulfill the following criteria:(i) Volunteer Should be from NSS only and must have completed one-year of volunteer
ship in NSS and preferably attended one NSS special camp (volunteer should bring
their NSS volunteers work diary with them OR a certificate by the Programme
Officer/Principal if diary is not provided as a documentary proof of volunteer ship).
(ii) Should be unmarried.
(iii) Height: 155-165 cm for girls and 165-175 cm for boys.
Weight: There should be no evidence of weak constitution, bodily defects or under
Weight or obese
(iv) Should be able to do the following
- Running upto 1.5 km in 10 minutes
- Should march constantly for 20 minutes
- Should give / listen command from 25 mtrs
- Should not have flat foot or knocked knee
(v) One volunteer may be given maximum of two chances to attend Pre-RD Camps
during volunteer ship
(vi) Participants should not be below the age of 16 years
(vii) Volunteer should possess good communication skill.
(viii) Any extra ordinary talent of the volunteer may be considered for selection to Pre RDC.
(ix) Volunteer must have a pleasing personality and smart appearance.
(x) Volunteer should be cooperative and courteousness.
(xi) Volunteer should be good in parade.
(xii) Volunteer should be medically fit.
NB : There should be a paramedical member during the selection process at different level.
Annex.-III
Certificate of Medical/Physical Fitness – A Specimen
Signature of the Candidate……………………………………...
I do hereby certify that I have examined Mr./Ms……………………………Son/Daughter
of…..…………………………… and found fit for undergoing rigorous training for Pre-Republic
Day/Republic Day Camp.
The candidate whose signatures are given above is not suffering any communicable or chronic
disease, which may cause any hindrance in his/her participation in the above-mentioned rigorous training
programme.
Signature of the Medical Officer
with Seal
Station:___________________
Dated:____________________
Annex.-IV
Form of Indemnity – A Specimen
In consideration of my being nominated at my request to undergo all types of
training and also participating in any camp/course/adventure training activities in/outside
NSS and traveling I undertake and agree that neither I nor my executer/ administrator will
make any claim against the Government of India or against any officer of
NSS/Principal/Programme Officer/ Programme Coordinator/State Liaison Officer/Youth
Officer/ Assistant Programme Adviser/Deputy Programme Adviser/ Programme Adviser 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/ participating in any
camp/course/adventure training activities in/ outside NSS and traveling and I understand that
no compensation will be paid by Government of India or any Officer as mentioned against
any such loss or injury (including injury resulting in death) and I agree so as to bind myself,
executers and administrators to indemnity to the Government of India, any NSS official and
any person in the service of Government of India, against any claim which may be made any
third party against them or any of them arising out of any ac or default on my part during or
in connection of said training camp/course/NSS Pre-RD Parade/RD Parade Camp/adventure
training and journey by road/rail/sea/river/flight.
Signatures of the applicant with address
In the presence of
Witness 1
___________
Witness 2
___________
NB: One of the witnesses must be the parent/guardian of the NSS volunteer with
address
Annex.-V
Volunteer ship Certificate – A Specimen
It is certified that Shri./Kum………………………………. Son/Daughter of
Shri……………………………. is a bona-fide student of (name of institution)
…………………………………
He/ She is a regular NSS volunteer from……………. and has completed his/her one
year of volunteer ship and he/she is neither a member of NCC nor a member of Scouts and
Guides/ Rovers/Rangers.
He has attended NSS Special camp from…….to…… (Date) at…… (Venue)
Signatures of the Programme Officer
with seal
Signatures of the Principal
with seal