Savitribai Phule Pune University, Pune National Service Scheme Adventure camp Narkanda, Himachal Pradesh List of Selected Volunteers Dt. 28 Feb 2015 to Dt.9 March 2015 No M1 Volnteers Name Pune City Pratik Sangale M2 Sahil Kelkar M3 Kunal Chormule College Abasaheb Garware College, Karve road, Pune –411 004 Std T.Y.B.A. Kannada Sanghas, Kaveri College of Sci & commerce, Erandwane, Pune Sir Parshubhau College, Pune Mob 9503295098 8007189711 Appasaheb Jedhe College, Pune F4 F5 Krutika Surya M6 Pune Rural Ravindra Naikodi M7 Yadav Chetan Chagan Arts & Science College Kalamb Walchandnager, Indapur, Pune F.Y.B.A. F8 Diksha Ramdas Bhujbal Arts, comm. college Talegaon Dhamdhere, Tal- Shirur T.Y.B.Com 7276327318 F9 T. J. College, Khadaki, Pune T.Y.B.Com 9762338546 F10 Vyankatrajani Ramayya B. Gauri Shahaji Supute M.S. Kakade Mahavidyalay Someshwar Nagar 7507021031 M11 Ahemadnager Pande Sagar Shivaji M12 Khatale Sharad Sahadu M13 Amit Annasaheb Dhage F14 Shejwal kajal kisan F15 Jadhav Joti Sampat Bharti Vidyapith Engineering College, Pune 7798826565 Arts & Science College Nimgaon Sava, Junner, Pune 8600383003 Sangamner Nagarpalika Arts, D. J. Malpani Comm. & B. N. Sarada Sci. College, Sangamner, S.Y.B.A. 9762056667 Dhanvantari Arts & Science College Dhavalpuri Shri Saibaba Institute of Engineering Research & allied science, Rahata Ramesh Phirodia Arts,Comm. & Science College, Sakur, Tal- Sangamner,Dist- A’ Nagar F.Y.B.A. 8390899495 S.Y.B.Sc 9527136411 Arts Comm. & Sci. College, Alkuti, Tal – Parner Dist- A’ Nagar S.Y.B.A. c/o 9404311/23 8446250091 M16 Nashik Roshan Shevale M17 F18 Raite Satish Shashikant Pooja Haribhau Jadhav F19 Sarasvati Tukaram Jadhav F20 Chetana Dinesh Sharma MTeam Leader FTeam Leader Dr. Deepak Gaikwad K. K. Wagh College of Engineering, Vidyanagari, Panchavati, Dist – Nashik K.T.H.M. College, Nashik NVPM Arts, Sci. & Commerce College Lasalgaon, Tal – Niphad, Dist – Nashik K. K. Wagh Arts, Sci. & Comm., College, Pimpalgaon (B), Tal – Niphad, Dist – Nashik – 422 209 KSKW CIDCO College Nashik – 422 403 Shahu Mandir ASC College, Parvati, Pune T.Y.B.Eng. 9405667157 S.Y.B.Com 8888243145 S.Y.B.Com 8605343927 8605705795 S.Y.B.A. 9011233345 9637757896 7350179009 9049097037 Programme Coordinator National Service Scheme 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
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