UNDERTAKING (To be executed on non-judicial stamp paper of denomination Rs. 100/- or above. No need to type

on stamp paper & no need to notarise. Take a print out of this page and staple it to the stamp paper) 1. Upon my request, the Bhabha Atomic Research Centre, Government of India, have kindly agreed to afford me training facilities in (subject) __________________________ at their ______________________________Division/Plant. The duration of the training course is proposed to be from dated __________________ to __________________. 2. I hereby undertake that I shall, during the period of training with BARC, abide by the terms and conditions as hereinafter appearing that a) I shall at all times, conform to the rules and regulations of the Research Centre as may be prescribed from time to time b) I shall at all times observe the health safety precautions including wearing of uniforms/film badges as may be prescribed for entry into the plant/place of work. c) I shall be liable to make good any loss or damage to the property of BARC caused due to my carelessness or negligence during the course of my training. d) In the event of an accident, causing injury/disablement to me or my death during the period of my training BARC or any of its employees will not be liable to pay any medical expenses or compensation and that no claim either or my or on my behalf by dependents/heirs/clients will lie against BARC or any of its employees. 3. I, _____________________________________ son/daughter of _______________________ student of ______________ year/semester in _____________________ (subject) at ______________________________________________________ (name of college with city and state) college/institution and residing at _____________________________________________ (permanent residential address) have read “The Indian Atomic Energy Act, 1962” and agree to abide by their provision. Further, I hereby solemnly declare that I shall not directly communicate or cause to be revealed, to any person or persons any information which has come or may come into my possession in the course of my training with BARC except with the written permission from the competent authority of BARC. Date: Place: Signature of The trainee: ________________________________ Sr. No. of Non-Judicial Stamp Paper: Witness 1):_________________________________ (Signature) & Date of Purchase:______________ ________________________________ (Name & Address) ________________________________

Date: ________________________________

Witness 2): ________________________________ (Signature) Signature on Behalf of the ________________________________ President of India (Name & Address) ________________________________ Head, Human Resource Development Division Date:_____________________________

DEED OF UNDERTAKING(To be executed on plain paper)

In consideration of my being allowed by Bhabha Atomic Research Centre at my request to undergo project training as part of my education curriculum at ____________________(Division) for_______________________________ course, I__________________________________________s/d/o____________________resident of _______________________________________________________________________________________ (complete residential address) undertake and agree that neither I nor my executors or administrators will make any claim against the Government of India against any injury or loss arising out of any willful act of commission or omission on my part during the said training and I understand that no compensation will be paid by the Government of India in respect of such injury or loss.

I further agree so as to bind myself, my executors and administrators to indemnify the Government of India against any claim which may be made against them for any injury or loss suffered by a third party due to any willful act of commission or omission on my part. The Government has agreed to bear the stamp duty on this document. Signature: ____________________________ Signed this ____________________day of ______________20____ In Presence of: 1. Signature : ___________________________________ Name (in block letters) ______________________________________ Address___________________________________________________ 2. Signature : ___________________________________ Name (in block letters) ______________________________________ Address___________________________________________________ Parent’s Signature________________________________________

GAZETTED OFFICER’S CERTIFICATE

This is to CERTIFY that *Dr/Shri/Smt/Kum_________________________________________ son/daughter/wifeof Shri _______________________________________________________ residing at__________________________________________________________________ is personally known to me for last ______years. To the best of my knowledge and belief he/she bears a good moral character and has no antecedents which would render him / her unsuitable to enter BARC (Bhabha Atomic Research Centre) premises, which is a prohibited area. Place:_______________ ___________________________________ Date :_______________ Signature with Official seal

(GovernmentGazettedOfficer only) Name:

DECLARATION 1. Upon my request, the Bhabha Atomic Research Centre (BARC) Government of India, have

kindly agreed to issue Temporary Entry Pass (TEP) to visit BARC premises for ____________________ during the period from dated _____________ to _____________. 2. I hereby undertake that, during the visit to BARC, I shall abide by the Terms and Conditions as hereinafter appearing that a) I shall at all times, conform to the rules and regulations of the Research Centre as may be

prescribed form time to time b) I shall at all times observe the health safety precautions as may be prescribed for entry into

the plant/place of work. c) I shall be liable for any loss or damage to the property of BARC caused due to my

carelessness or negligence. d) In the event of an accident, causing injury/disablement to me or my death, BARC or any of

its employees will not be liable to pay any medical expenses or compensation and no claim either on my or on my behalf by dependents/heirs/clients will lie against BARC or any of its employees.

3. I agree that, neither I nor my executors or administrators will make any claim against the Government of India against any injury or loss arising out of any willful act of commission or omission on my part during the said visit and I understand that no compensation will be paid by the Government of India in respect of such injury or loss. 4. I further agree so as to bind myself, my executors and administrators to indemnify the Government of India against any claim which may be made against them for any injury or loss suffered by a third party due to any willful act of commission or omission on my part. 5. I, _____________________________________ resident of ________________________ ___________________________________________________________________ (permanent residential address), hereby solemnly declare that I shall not directly communicate or cause to be revealed, to any person or persons any information which has come or may come into my possession during the visit except with the written permission from the competent authority of BARC. Date: Place: Signature of applicant: _______________________________ Witness 1):_____________________________ Witness 2):___________________________ (Signature) (Signature) _____________________________ ___________________________ (Name & Address) (Name & Address) _____________________________ ___________________________ Date : _________________ Date: _________________ Chief Administrative Officer (P) Personnel Division BARC, Trombay Mumbai – 85.

Check List for Summer Training/Project Work Students SN Document

Pl tick 1. Acceptance Letter from BARC 2. Bio-data Form a. Photo signed across by college authority alongwith seal b. Certificate signed by college authority alongwith seal

3. Deed of undertaking signed by a. Student b. Two witnesses – other than blood relation c. Parent

4. Undertaking duly signed by a. Student

b. Two witnesses – other than blood relation (no need to type on stamp paper & no need to notarise. Take a print out of undertaking and staple it to the stamp paper)

5. Duly completed Information Sheet signed by college authority with seal 6. Character Certificate from Gazetted Officer other than from college 7. Photocopy of College Identity Card attested by College Authority with signature

and seal. College ID card should have clear validity till end of Training period.

Documents for Identity Card (To be carried but not to be submitted at BARC Training School) 8. Declaration duly signed by student & 2 witnesses. 9. Temporary Entry Permit form (Printed Back to Back) (specify Aadhaar No on top)

10. Two copies of Passport Photograph (4 cm X 3 cm) - Front Facing

11. A Demand Draft for ₹200 only of Nationalized Bank in favour of “Accounts Officer BARC” payable at Mumbai(applicable to those students who do not wish to pay ₹200/- using credit card or debit card).

Please Note: 1. Applicant(s)/representative may drop the set of documents (1-7), stapled together & placed in envelope, in a box kept near canteen at the Training School Premises at ‘A’ wing entrance during working hours (10.00 a.m. to 6.00 p.m.) 2. Applicants who have applied in a group should also submit forms in a group. 3. Introduction letter(s) after scrutiny of documents will be issued at Computer lab no.1, 1st floor, BARC Training School, between 10:30 to 11:45 hrs. only on Mondays(for applications dropped from Wednesday Afternoon to Friday Forenoon of the previous week) and on Thursdays (for applications dropped from Friday Afternoon of the previous week to Wednesday Forenoon). In the event of a holiday on Monday or Thursday, the intimation letters will be issued on the next working day.

Signature of Student