Enrollment Proforma for YRC Volunteer

(To Be Filled in CAPITAL Letters)

Email address *
Name of the Volunteer *
Gender *
Father's Name *
Mother's Name *
Date of Birth *
MM
/
DD
/
YYYY
Category *
Area *
Religion *
Programme *
Semester *
Roll No/ Enrollment No
Hostel Room No (If Applicable)
Hobbies/Interests
Special Interest: If you have participated in School/ College/ Univeristy in NSS/NCC/YRC/Cultural/Sports/Blood Donation/Adventures activities. Please attach the scanned file:
Scanned attachments for Special Interest(.PDF,.JPEG,.DOCX)
Passport Size Photograph (Less than 100 KB)
Are you Medically fit for YRC (If not mention problem) *
Permanent Address: *
Pin Code: *
Correspondence Address *
Pin Code: *
Aadhar No *
Blood Group
Contact No *
I hereby declare that I shall abide by rules and regulations of YRC and I will give my best to the society with sincerity *
Required
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