lanhkz %

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1 ZZ lanhkz % jkls;ks@645 fn- 11 ekpz Z 2013 Ikzfr Ekk- izkpk;z@jkls;ks dk;zøe vf/kdkjh jk Vªh; lsok ;kstuk dk;zjr vlysyh loz layxu egkfo ky;s iq.ks] vgenuxj o ukf kd ftygk fo k; % lu 2012&20 &2013 lkbh ftygklrjh;] fo kihb] jkt;lrjh;] ] jk Vªh; iqjldkjklkbh izlrko ikbfo.kslaca/kh--- egksn;] njo khzizek.ks lu 2012&2013 lkbh ftygk] fo kihb] jkt;lrjh; o bafanjk xka/kh jk Vªh; iqjldkjklkbh fofo/k egkfo ky;akdmwu izlrko ekxfo.;kr ;sr vkgsr- mrd` V Lo;alsod@dk;Zdze vf/kdkjh@egkfo ky; ;akp;klkbh vls iqjldkj jk Vªh; lsok ;kstusp;k jksi;egksrloh o kkziklwu fo kihb] egkjk Vª kklu o dsanz kklu ;akpsdmwu fnys tkrkr- iq.ks fo kihbkvarxzr ftygk o fo kihb ikrghojgh vls iqjldkj fnys tkrkr- izlrko ikbforkuk d`ik;k [kkyhy xks Vh y{kkr?;ko;kr ;kr- 1½ mrd` V jkls;ks,dd@mrd` V dk;zøe vf/kdkjh vkf.k Lo;alsod@Lo;alsfodk ;akpk izlrko ikbforkuk izr;sdh,dp izlrko fo kihbkdms ikbfo.;kr ;kok-,dk egkfo ky;krwu izr;sd izdkjklkbh,dkis{kk tklr izlrko ikbfoy;kl R;kpk fopkj dsyk tk.kkj ukgh- 2½ izlrkoke/;s [kkyhy xks Vhapk lekos k djkok % izlrkokp;k eq[ki` Bkojhy etdwj [kkyhyizek.ks vlkok- ejkbh izlrkoklkbh % jkt;lrjh;@fo kihb@ftygklrjh; jk Vªh; lsok ;kstuk iqjldkjklkbhpk izlrko- Lo;alsod@dk;Zdze vf/kdkjh@egkfo ky;,dd uko P.T.O.

2 ss baxzth izlrkoklkbh % 1- Proposal for National Service Scheme Indira Gandhi National/State/University/District Level Awards. 2- College/Programme Officer/Volunteer Name should appear. vuqdzekf.kdk (Contents) lkscr uequ;kizek.ks baxzth o ejkbh uequ;krhy vtz (Performa in English and Marathi) 3½ mrd` B,dd@dk;ZØe vf/kdkjh & ekxhy rhu o kkzp;k fu;fer dk;zdzekaph o fo ks k f kfcj dk;zdzeakph ekfgrh mrd` B Lo;alsod@Lo;alsfodk & ekxhy nksu o kkzp;k fu;fer dk;zdzekaph o fo ks k f kfcj dk;zdzeakph ekfgrh ukfou;iw.kz dk;zdzeakph ekfgrh (Innovative Programme) brj dkgh dk;zdzekaph ekfgrh (Any Other Activities) izr;{k lektdk;z djrkuk?ksrysyh dkgh Nk;kfp=s (Few Action Photo s) iz kalki= (Certificates/Application letters if any 4½ 5½ 6½ 7½ 8½ 9½ 10½ lkscr tksmysy;k izlrkokp;k uequ;kojp ekfgrh Hk:u ikbow u;s- uequk,&4 dkxnkoj Vadfy[khr d:u?;kok- izlrkoke/khy etdwj Vadfy[khr dsysykp vlkok- izlrko dks.kr;kgh ifjflfkrhr 100 ikukis{kk tklr ulkok- rsogk izlrkoke/;s QDr egrokp;k o ekxhy rhu o kkzp;k ekfgrhpk lekos k vlkokuequ;ke/;s fu/kkzfjr dsysy;k tkxsoj laca/khr vf/kdkú;akph Lok{kjh o f kddk vlkokizlrko ejkbh o baxzthe/;s Lora=i.ks nksu izrhr lknj djkok- ojhy izlrko fo kihbkdms ikbforkuk,&4 ;k vkdkjkp;k dkxnkoj ekfgrh,df=r d:u rh ckbzfmax d:u ikbokohdk;zdze vf/kdkjh@lo;alsod@lo;alsfodk ;akuh izlrko ikbforkuk izlrkokp;k uequ;koj,d frfdvkp;k vkdkjkps jaxhr Nk;kfp= o,d Nk;kfp= vtkzlkscr ikfdvke/;s can d:u ikbokos- nksugh izlrkoklkscr Loar=i.ks nksu QksVks vlkosr- rjh ojhy iqjldkjklkbh izlrko fo kihbkdms fnuakd 10 es 2013 iwohz ikbokosr- viw.kz vlysys o vafre rkj[ksuarj izkir >kysys izlrko dks.kr;kgh ifjflfkrhr flodkjys tk.kkj ukghr ;kph dìk;k uksan?;koh- dgkos] vkiyh fo oklw] lkscr % izlrkokps uequs dk;zøe leuo;d jk Vªh; lsok ;kstuk

3 jk Vzh; lsok ;kstuk vf/kdkjh ;akuh ikboko;kp;k izlrkokpk uequk 1- jkt; % ikslvfrdhv vkdkjkpk QksVks 2- fo kihbkps uko % 3- egkfo ky;@lalfksps uko o iw.kz irrk@ bz esy irrk % fiu dksm % nqj/ouh dzeakd 4- izkpk;kzaps uko % 5- dk;zøe vf/kdkú;akps uko] fuoklh irrk] o nqj/ouh Øeakd] bzesy irrk] eksckbzy Øekad% fiu dksm % nqj/ouh Øeakd % 6- jk- ls- ;ks- dk;zøe vf/kdkjh Eg.kwu lsok dky &&&& iklwu &&&&&&Ik;Zar 7- dk;zøe vf/kdkjh izf kf{kr vkgs dk;\ ¼vlY;kl izek.ki= tksmkos½ ukgh

4 8- iqjldkjklkbh dk;zjr vlysys,dd fdrh o d/khiklwu dk;zjr vkgs \ 9- ekxhy 3 o kkzrhy eatwj o izr;{k uksanfoysyh fo kfkhz la[;k- v- Ø- o kz eatwj fo kfkhz la[;k izr;{k uksanoysys fo kfkhz iq: k fl=;k,dw.k fo ks k f kfcj dk;zøekps mfnn~ V % v- Ø o kz y{k lk/; 11- nrrd xkokps uko@ukxjh olrh laidz lk/kko;kp;k O;Drhps uko o egkfo ky;kiklqu varj % 12- xkokae/khy lk/; dsysys lk{kjrsps izek.k % 13- ekxhy nksu o kkzr mhkkj.;kr vkysys % LFkk;h izdyi dk;z ¼lfoLrj rif ky tksmkok½ 14- jk- ls- ;ks- miøe vf/kd xfr khy dj.;klkbh Lo;alsod dk;zøe vf/kdkjh ;akuh brj lalfkkp;k ek/;ekrwu dsysys iz;ru % 15- vgoky o ys[ks ikbfo.;krhy lkrr; % vgoky dks.kr;k efgu;kr ikbfoys vkgsr \ ys[ks dks.kr;k efgu;kr fo kihbkl lknj dsys vkgsr \ rif ky fygkok- 16- dks.krhgh U;kf;d vfkok fohkkxh; pksd kh dk;zøe vf/kdkú;kfo:/n pkyw vkgs dk; \ 17- dk;zøze vf/kdkú;kpk lozlk/kkj.k n` Vhdksu 18- jk Vªh; lsok ;kstusrhy Lo;aeqY;ekiu

5 aa 19- jk Vªh; lsok ;kstusr vki.k dsysy;k khy miøeakpk ri khy 20- Vªh;Lrjkojhy fofo/k miøekarhy ;ksxnku 21- vfhkizk;] dkgh vly;kl 22- egkfo ky;kus jk Vªh; lsok ;kstuk fohkkxkl iqjfoysy;k lsok o lqfo/kk v- dk;kzy; c- lk/ku lkeqxzh d- vxzhe O;oLFkk M- fdrh dezpkú;akps dk;zøe vf/kdkú;kl lgdk;z fegkysb- f k{kd bz- f k{kdsrj dezpkjh dk;zøe vf/kdkú;k ;ka aph lgh izkpk;z Lok{kjh kjh o f kddk dk;zøe leuo;d ;dkaph Lok{kjh ek- dqyxq: ;akph Lok{kjh o f kddk ek- jkt;laidz vf/kdkjh Lok{kjh

6 jk Vªh; lsok ;kstuk iqjldkjklkbh Lo;alsodakuh ikboko;kp;k izlrkokpk uequk- ikslvfrdhv vkdkjkpk QksVks 1- jkt; % 2- fo kihbkps ukao % 3- egkfo ky;@lalfksps ukao o laiw.kz irrk % fiu dksm % nqj/ouh Øeakd % 4- izkpk;kzaps uko % 5- iqjldkjklkbh izlrkfor jkls;ks Lo;alsodkps ukao o tuerkjh[k 6- fyax % iq: L=h 7- Lo;alsodkpk fuoklh irrk o nqj/ouh Øeakd fiu dksm % nqj/ouh Øeakd % Hkze.k/ouh % bz&esy %

7 aa 8½ Lo;alsod Eg.kwu fdrh rkl dke dsys\ &&&&&&&&&&& rkl 9½ jk-ls-;ks- Lo;alsodkapk dkyko/kh &&&&&&& iklwu &&&&&& Ik;Zar 10½ jk-ls-;ks- Mk;jh r;kj dsyh vkgs dk; \ ¼>sjkWDl izr lkscr tksmkoh½ 11½ fdrh fo ks k f kfcjkr lghkkx?ksryk vkgs\ lnj f kfcjkr vki.k dk; f kdykr lnj f kfcjkr vkiys ;ksxnku ¼lfoLrj rif ky kok½ 12½ ftygk@fo kihb@jk Vªh; Lrjkojhy f kfcj@dk;zdzekr lghkkx?ksryk vkgs dk;\ gks; vly;kl] lfolrj ri khy tksmkok- 13½ jdrnku] us=nku] o`{kkjksi.k] fulxz] lk{kjrk] vkjksx; f k{k.k] lektksuurh] losz{k.k b- dk;zdzekrhy lghkkx ¼lfoLrj rif ky tksmkok-½ 14½ nrrd?ksrysy;k olrhe/;s yksdakuk lektlsoslkbh izksrlkfgr dj.kkjs dk;z o R;klkBh nk[kfoysys usr`ro- ¼lfoLrj rif ky tksmkok-½ 15½ U;kf;d vfkok vu; dqby;kgh ;k izdkjph pksd kh pkyw vkgs dk; \ 16½ lozlk/kkj.k vfhkizk; 17½ brj myys[kuh; dkefxjh ¼lfoLrj rif ky tksmkok-½ 18½ ikl >kysyh ijh{kk ¼ ksovp;k ijh{ksps ekdz khv tksmkos-½ 19½ Lo;aeqY;ekiu] jk- ls- ;kstusrwu vki.k dk; f kdykr \ ;kpk okij vkiy;k thoukr dlk gksrks- 10 vksghr fygk- ukgh 20½ jk-ls-;ks- e/;s vki.k dsyssys l`tu khy] ukfo.;iw.kz midzekaph ekfgrh n;koh- dk;zdze vf/kdkjh Lok{kjh Lo;alsod Lok{kjh izkpk;kzaph Lok{kjh dk;zøe leuo;dka aph Lok{kjh ek-dqyxq: ;akph Lok{kjh o f kddk ek- jkt;laidz vf/kdkjh ;akph Lok{kjh

8 PROFORMA FOR RECOMMENDING NSS UNIT & PROGRAMME OFFICER FOR NSS AWARD Stamp size colour Photograph 1. State : 2. Name of the University with full address : ( in Block letters) Pin Code : 3. Name of the affiliated College/ Institution (In Block letters with address) Phone Nos.: Pin Code : Telephone No.: 4. Name of the Principal 5. Name of the Programme Officer :(In Block letters & Residential Address with phone number Mobile, ) Pin Code : Telephone Nos.:

9 6. Period of Services as NSS Programme Officer of the NSS Unit : From To 7. Whether trained (give details) : Yes/No. 8. Period of existence of the NSS Unit which is being Recommended for the award : 9. Allocation & Actual Enrolment of NSS Volunteer for the last 3 years. Sr. No Year Allocation Actual Enrolment Male Female Total 10. Special Camping Target (last 3 year) Sr. No. Year Target Achievement 11. Name of the adopted Village/Slum : Urban Slum (with name of the Contact person/ Sarpanch/ : Village Head also mention Distance From the college 12. Percentage of Literacy achieved In the Village : 13. Durable assets created during the : Past 2 years or other achievements (Give actual details in separate sheet) (CCT, Plantation) 14. Initiative taken by the Programme : Officer in strengthening the Programme activities during past 2 years involving NSS volunteers and other local developmental al agencies. (Attach detailed report) 15. Regularity in submission of Yes / No Report and Accounts. 16. Whether the Programme Officer Yes / No

10 Has been convicted by any Court Of Law or any case is pending Against him/her 17. General attitude of the : Programme officer 18. Self evaluation in NSS : 19. Innovative ideas inculcated/ Implemented in NSS : 20. District/ University/ State/ National level contribution : (Give details) 21. Availability NSS: 1) Office : 2) Infrastructure : 3) Advance : 4) Help of other i) Teacher ii) iii) Non Teaching Staff Other Signature of the Programme Officer Signature of the Principal Signature of the Programme Co-ordinator Signature of the Voice Chancellor with official seal Signature of the State Liaisons Officer

11 1. State : PROFORMA FOR RECOMMENDING NSS VOLUNTEERS FOR NSS AWARD Stamp size colour Photograph 2. Name of the University with full address : Pin Code No : Telephone No.: 3. Name of the affiliated College : (With full address) Pin Code: Contact No.: 4. Name of the Principal : 5. Name of the Volunteer who is Being Recommended and Date of Birth.:

12 6. Sex : Male/Female 7. Full residential address with Pin code Telephone No. (Residence) Mobile, Pin Code: Mobile No.: Contact No.: Id : 8. No. of hours completed during Hours. NSS Volunteership 9. Period of NSS Volunteers ship From To Whether Maintained NSS diary Yes/ No (Attach Xerox Copy) 11. No. of NSS Special Camps attended (Give details of each camp) 12. University/ State/ National Level Yes/ No Programme/ Training attended, (Give details of each camp) 13. Contribution in Blood donation : Eye donation pledge. Tree plantation, Environment preservation, Literacy, Health Education Community Development work etc. (Give details) 14. Leadership qualities and other : Initiative to motivate other youth in Uplifting social-economics conditions, of the adopted community (Give details) 15. Whether he/she has ever been : Convicted by any court of law or any case is pending against him/her.

13 16. General Attitude : 17. Any outstanding performance : (Attach separate sheet with full factual details) 18. Examination passed : (Attach Mark sheet) 19. What are your 1 yearnings through self : Evaluation write in details 20. Innovative ideas you have : Suggested/implement in NSS Signature of the student Signature of the Programme Officer Signature of the Principal Signature of the Programme Co-ordinator Signature of the Vice Chancellor With official seal Signature of the State Liaisons Officer