Part A: Proforma for Recommending UNIVERSITY/ +2 COUNCIL for NSS AWARDS

Name of the State/ UT* ----------Select State---------- SELECT * ANDAMAN AND NICOBAR ISLANDS ANDHRA PRADESH ARUNACHAL PRADESH ASSAM BIHAR CHANDIGARH CHHATTISGARH THE DADRA AND NAGAR HAVELI AND DAMAN AND DIU DELHI GOA GUJARAT HARYANA HIMACHAL PRADESH JAMMU AND KASHMIR JHARKHAND KARNATAKA KERALA LAKSHADWEEP MADHYA PRADESH MAHARASHTRA MANIPUR MEGHALAYA MIZORAM NAGALAND ODISHA PUDUCHERRY PUNJAB RAJASTHAN SIKKIM TAMIL NADU TELANGANA TRIPURA UTTARAKHAND UTTAR PRADESH WEST BENGAL LADAKH	Bank Account Number (Write Account Number which is linked with your Aadhar Number)	Name of the Bank.*
Branch of the Bank.*	Bank's MICR Code	Bank's IFSC Code*

Name of the University/ +2 Council, with address and other contact particulars

Name of the Vice-Chancellor/ Director of Senior Secondary Education/ Chairperson of +2 Council (with contact particulars)

Name of the Programme Coordinator (with contact particulars)

Date from which University/ +2 Council is operating NSS Programmes *

Number of NSS units under the University/ +2 Council(A) *

Total number of colleges/ schools having NSS(B)*

Whether strength of NSS units is as per guidelines?

Adoption of Villages/ Slums and completion of Special Camping targets

Whether the NSS functionaries under the University/ +2 Council have been convicted by a court of law or any case/ investigation is pending against any of them?* Select Yes No

Certificate from the competent authority of the University to be attached (Please upload PDF file only not greater than 2 mb)

Photo (Please upload jpg,png gif file only not greater than 2 mb)

Performance/ Significant Achievements of the University:

Whether the duly filled check list attached?* Select Yes No

Attached Certificate * (Please upload PDF, DOC only not greater than 5 mb)

Other Remarks, if any *

All Required Signature

Signatures of the Programme Coordinator* (Please upload jpg,png gif file only not greater than 2 mb)	Signature of the Vice Chancellor/ Chairman* (Please upload jpg,png gif file only not greater than 2 mb)	Signature of the SNO* (Please upload jpg,png gif file only not greater than 2 mb)
Signature of the Competent Authority in the State/ UT* (Please upload jpg,png gif file only not greater than 2 mb)

Please select duly filled to "YES".
Save & Next

Note- Since the Award is for the 2015-16, the Volunteers completing their 2 years’ volunteership during 2015-16 only are to be considered. The volunteers completing their volunteership prior to 2015-16 cannot be considered for the Award. For the same reason, the achievements of the volunteer shall be considered for the 2-year volunteership period, which would fall within last 3 years, i.e., 2012-13, 2013-14 and 2015-16.In other words, the NSS volunteer should have been a student, pursuing a regular course, at least for a part of the year for which he/ she is being nominated. The NSS volunteers should indicate his/ her personal achievements only, and not the achievements of the entire NSS unit. For instance, he/ she should indicate saplings planted/ blood donated by him/ her personally in a programme and not be the entire NSS unit

Note: * fields are Mandatory.