ikliksVZ lkb”kiQksVks fpidk,a

Paste passportsize photograph.

1. izkFkhZ dk uke@Applicants Name(in Block Letters) ......................................................................................................

2. tUe frfFk@D.O.B. .......................... pkyw o"kZ osQ 1 vizSy dks vk;q@Age as on 1st April of current year ................

3. fo|ky; dk uke@Name of School ..................................................................................................................................

4. d{kk@Class .........................................................................................................................................................................

5. firk@laj{kd dk uke@Father's/Guardian Name ...........................................................................................................

6. ekrk dk uke@Mother's Name .........................................................................................................................................

7. firk@laj{kd dk O;olk;@Father's/Guardian Occupation ..........................................................................................

8. dk;kZy; dk irk@Office Address ..................................................................................................................................

9. fuokl dk irk@Residence Address ...............................................................................................................................

10. nwjHkk"k@Tel. : dk;kZy;@Off. ........................................................... fuokl@Resi. ............................................................

eksckbZy@Mob..................................................... bZ&esy@E-mail ...................................................................................

fVIi.kh : oxZ osQ laca/ esa l{ke izkf/dkjh }kjk tkjh lR;kfir izfr layXu djsaA izos'k osQ le; ewy tkfr@oxZ izek.ki=k tkap gsrq izLrqr djsaANote : Attach attested copy of caste/category certificate issued by the Competent Authority. Show the original certificate at the time of admission)

* vuqlwfpr tkfr] tutkfr vkSj fnO;kax cPpksa osQ fy, okf"kZd 'kqYd ykxw ugha gS@No Annual Fee for SC, ST and Differently abled Children.

iathdj.k la[;k / Registration No. : ........................

vk;q oxZ / Age Group : .............................................

fyax / Sex : yM+dk / Boy yM+dh / Girl

leqnk; / Category : fdlh ,d ij üüüüü yxk,a / üüüüü any one

d Gen OBC SC*

d ST* DifferentlyAbled*

eSa fo'okl fnykrk gw¡ fd Åij fn;k x;k fooj.k esjs fopkj ls fcYdqy Bhd gSA eSaus vuqPNsn ^d* osQ lHkh funsZ"k vPNh rjg ls i<+ fy, gSaA eSa ;g lqfuf'prdjrk@djrh gw¡ fd esjk cPpk ;k esjh laLFkk@fo|ky; dk Nk=k@lnL; bu lHkh funsZ"kksa dk ikyu djsxk@djsxh ,oa viuh lqj{kk gsrq lHkh vko';d lko/kfu;k¡ ysxk@ysxh,oa ;fn dksbZ nq?kZVuk ?kVrh gS rks mlosQ fy, jk"Vªh; cky Hkou ftEesnkj ugha gksxkAI solemnly declare that the particulars given above are correct to the best of my knowledge. I have gone through the instructions atAnnexure ‘A’. I ensure that my ward will adhere to all the instructions and will take all necessary precautions to ensure his/her safetyand will not hold National Bal Bhavan responsible for mishap (if any).

fnukad gLrk{kj ekrk@firk@laj{kd

Date................................ Signature of Parents/Guardian

iathdj.k la[;k@Registration No. ..........................................

uke@Name ...............................................................................

mez@Age ...................................................................................

irk@Address ...........................................................................

.................................................................................................

nwjHkk"k@Phone ..........................................................................

iQkeZ 'kqYd 10/-

okf"kZd 'kqYd 100/-*

Øe la- / Sr. No. ............................

iathdj.k la[;k@Registration No. ..........................................

uke@Name ...............................................................................

mez@Age ...................................................................................

irk@Address ...........................................................................

.................................................................................................

nwjHkk"k@Phone ..........................................................................

dksVyk jksM+] ubZ fnYyh-110002 • Kotla Road New Delhi-110002

nwjHkk"k : 23234701 • Phone : 23234701

E-mail : membership.nbb@gmail.com

foKku dk;Zdyki /Science Activities

• D;ksa vkSj oSQls dk;Zdyki / How & Why Activity (10-16)

• HkkSfrd ,oa izkÑfrd foKku (xzh"edkyhu l=k esa) /

Physical and Natural Science (in summer)

• e'khu ekWMfyax / Machine Modelling (10-16)

• jsfM;ks vkSj bySDVªkWfud / Radio & Electronics (10-16)

• ,Wvjks ekWMfyax / Aero Modelling (10-16)

• lax.kd / Computers (10-16)

• i;kZoj.k] izkÑfrd foKku / Environment, Natural Science (5-16)

• [kxksy foKku / Astronomy (10-16)

• eNyh ?kj/Aquarium Related Activity (5-16)

iqLrdky; dk;Zdyki / Library Activities (5-16)

l`tu dyk,a / Creative Arts• fp=kdyk / Painting (5-16) • gLrdyk,a / Handicraft (5-16)

• cqukbZ / Weaving (5-16) • flykbZ / Needle Craft (5-16)

• dk"B f'kYi / Wood Craft (10-16)

• feV~Vh dk dke / Clay Works (5-16)

• ftYn lk”kh / Book Binding (10-16)

• Nk;kadu / Photography (10-16)

• feys tqys dk;Zdyki / Integrated Activities (5-16)

iznZ'ku dyk,a / Performing Arts

• daB laxhr ('kkL=kh; ,oa yksd) /

Vocal Musical (Classical & Folks) (5-16)

• ok| laxhr / Instrumental Music (10-16)

• 'kkL=kh; u`R; (dRFkd] HkkjrukV~;e) /

Classic Dance (Kathak, Bharatnatyam) (5-16)

• yksd u`R; (osQoy xzh"edkyhu l=k) /

Folk Dance (5-16) (only Summer)

• ukV~; dyk / Dramatics (5-16)

'kkjhfjd dk;Zdyki / Physical Activities• cSMfeaVu] Vscy Vsful] ckLosQVcky /

Badmintan, Table Tennis, Basketball (10-16)

• twM+ks / Judo (10-16)

• LosQfVax / Skating (5-16)

• fØosQV / Cricket (10-16)

laxzgky; rduhd (osQoy xzh"edkyhu l=k) /Museum Technique (5-16) - only summer

izdk'ku / Publication (5-16) - only summer

x`g izca/ ,oa [kkuk idkuk (osQoy xzh"edkyhu l=k) /Home Management & Cookery (5-16)

osQoy dk;kZy; iz;ksx osQ fy, / for office use only

cSt iQhl / Badge Fee ..........................................................

iathdj.k iQhl / Registration Fee ......................................

cl iQhl / Bus Fee ...............................................................

oqQy ;ksx / Total ...................................................................

jlhn la[;k / Receipt No. ....................................................

fnukad / Date ........................................................................

cl :V la[;k / Bus Route No. ..........................................

cl LVki / Bus Stop.............................................................

fuEufyf[kr nLrkost izos'k&i=k osQ lkFk tek djkus gksaxsA1- LowQy fiazfliy }kjk tkjh izek.k&i=k ftlesa LowQy fjdkMZl osQ vuqlkj cPps dh tUefrfFk n'kkZbZ xbZ gks vFkok tUefrfFk n'kkZrk LowQy

igpku i=k] vk/kj dkMZ] ikliksVZ bR;kfnA2- nks gky gh dh iQksVksxzkiQ (ikliksVZ lkbt)uksV % (i) ,d ckj iQhl tek djkus osQ ckn ykSVkbZ ugha tk,xhA (ii) cl 'kqYd vyx ls ns; gSA

The following documents must be submitted along with the application for registration1. A Certificate from the School Principal stating Date of Birth as per school records or date of birth showing School ID-

Card, Aadhar Card, Passport etc.2. Two recent Photographs (Passport Size)Note : (i) Fees once paid will be not be refunded. (ii) Bus fees to be paid extra.

dk;Zdyki / Activity-1

fnukad / Date ....................

dk;Zdyki / Activity ..........................................................

d{kk dk le; / Time of Class .........................................

izf'k{kd osQ gLrk{kj / Instructor's Signature

dk;Zdyki / Activity-1

fnukad / Date ....................

dk;Zdyki / Activity ..........................................................

d{kk dk le; / Time of Class .........................................

izf'k{kd osQ gLrk{kj / Instructor's Signature

xzh"edkyhu l=k ebZ&twu esa 5&10 lky osQ cPpksa dks fo'ks"k feyh&tqyh xfrfof/;k¡ djokbZtk,axhA ckdh dh 2 fØ;kdyki os xzh"edkyhu l=k osQ ckn dj ldrs gSaA@Duringsummer session of May-June seperate Integrated Activity will beconducted for children between 5-10 years. 2 activities chosen will becontinued after summer only.

Annure ‘A’

Important Instructions for Children and Parents1. Once the I-Card has been issued, all children must enter National Bal Bhavan wearing the I-

Card otherwise they would not be allowed in. Children availing the Bus Facility would not bePermitted to board the Bus (provided during summer) unless they have their specific identifycard with them. Prior to issue of I-Card the payment receipt must be brought along.

2. All the children must be present in their activity room. Children loitering around withoutany reason would be debarred.

3. No child should bring with him/her any valuable items substantial money, jewellery, camera,mobile phones etc.

4. No materials for Activity are required to be got from home so children should not bring anyactivity related material with them.

5. All care is taken in Bal Bhavan for the Safety and Security of children but support and cautionis expected from children too. Parents must instruct children to adhere to all safety norms.For safety reasons no one should touch any unidentified objects like bag, camera, purse,bottle, tiffin, radio, toy etc. as it may be dangerous. This would help avert danger. If a childspots an unidentified object he/she should immediately inform security/In charge of activity.no child should go near the rail track, loco shed area, turn table area, tunnel, bridge.membership will be cancelled if anybody is found loitering around any of the abovementioned prohibited areas.

6. The cleanliness of the premises must be maintained at all the times. Dustbins must be used todispose litter. Flowers and leaves must no to be plucked not plants uprooted.

7. Nobody is allowed to go outside during activity timing Security Staff is instructed not to let anychild go out from main door during this period.

8. No parents are allowed inside the class and nor are they allowed outside the class.

9. Use of mobile phones is not allowed inside the premises.

10. First Aid Posts is in the Hostel. Incase of any emergency/injury child must be taken thereimmediately.

11. Children travelling by bus must report at Open Air Theatre at 12:30 afternoon everyday.

12. Boys above 13+ can participate in activities only after 2:00 p.m. (During Summer Fiesta). Busfacility during Summer Fiesta will not provided to boys above 13 years.

13. This is a children's institution and its sanctity must be maintained at all the times hence smoking,consuming alcohol and any other intoxication is strictly prohibited.

14. When the children depart for their homes and get down at their respective stops, they mustwait there till their parent/guardian comes to pick them up. THEY MUST NOT GO AWAYFROM THE DESIGNATED STOPS. The parents however must ensure that they are at the busstops well in advance to receive the children on their return. Children must not talk to anystranger nor take lift from them.

15. National Bal Bhavan takes utmost care for the security and safety of children from the time theyboard and up to the times they de-board the buses, inside the buses and the premises and alsoduring activity hour.

16. Multiple photocopies of I-Card, Bus Card to be retained by Children/parents. In case of loss ofI Card/Bus Card duplicate card shall be issued on the basis of photocopy only.

Parent's Copy

vuqPNsn ^d*

xzh"edkyhu l=k esa lnL; cPpksa vkSj vfHkHkkodksa osQ fy, ”k:jh funsZ'k1- lHkh lnL; cPps jk"Vªh; cky Hkou }kjk fn;k x;k igpku&i=k xys esa igu dj vk,saxsA vU;Fkk izos'k o£tr

gSA cl lqfo/k ysus okys cPps viuk fo'ks"k igpku i=k (xzh"edkyhu l=k esa fn;s tkuk okyk) ges'kk viuslkFk j[ks vU;Fkk cl esa ugha p<+us fn;k tk,xkA igpku&i=k ugha feys gksus dh fLFkfr esa 'kqYd&jlhnfn[kkuh gksxhA

2- dksbZ Hkh cPpk xfrfof/ d{k ls ckgj ugha ?kwesxkA

3- dksbZ Hkh cPpk vius lkFk dherh lkeku] vkHkw"k.k] T;knk :i;k&iSlk] oSQejk vkfn rFkk xfrfof/ osQ fy,dksbZ Hkh O;fDrxr lkeku ugha yk,xkA

4- dksbZ Hkh cPpk vius ?kj ls dk;Zdyki osQ fy, dksbZ Hkh lkeku ugha yk,xkA

5- lqj{kk dkj.kksa ls dksbZ Hkh cPpk lafnX/ oLrq tSls & cSx] oSQejk] ilZ] cksry] fVfiQu] jsfM;ks vkfn dks ughaNq,xkA ;s oLrq, ?kkrd gks ldrh gSaA ,slh pht dh lwpuk viuh bapktZ ;k lqj{kk foHkkx dks rqjar nsuh gSAdksbZ Hkh cPpk jsyos VªSd osQ ikl] yksdks 'kSM ,fj;k] VuZ Vscy ,fj;k] xqiQk ;k fczt osQ ikl ugha tk,xkA;fn dksbZ Hkh cPpk bu {ks=kksa esa ?kwerk gqvk ik;k tk,xk rks mldh lnL;rk rqjar jn~n dj nh tk,xhA

6- lHkh cPps jk"Vªh; cky Hkou ifjlj dks lkiQ j[ksaxsA [kkyh iSosQV] owQM+k bR;kfn owQM+snku esa Mkyk tk,A dksbZHkh cPpk ifjlj esa iwQy] isM+&ikS/s rFkk iÙks ugha rksM+sxkA

7- fdlh Hkh cPps dks ifjlj ls ckgj xfrfof/;ksa osQ le; esa tkus dh vuqefr ugha gSA

8- fdlh Hkh vfHkHkkod dks xfrfof/ d{k esa tkus rFkk d{k osQ ckgj cSBus dh vuqefr ugha gSA

9- dksbZ Hkh cPpk vius lkFk eksckby iQksu ugha yk,xkA

10- izkFkfed fpfdRlk d{kk Nk=kkokl esa gSA vkikrdkyhu fLFkfr@?kk;ykoLFkk esa rqjar cPps dks ogk¡ ys tk;ktk,A

11- clksa esa tkus okys cPps izfrfnu 12%30 cts [kqys jaxeap esa fjiksVZ djsaA

12- xzh"edkyhu l=k esa 13 o"kZ ls vf/d vk;q osQ yM+osQ viuh xfrfof/ osQ fy, 2%00 cts ls mifLFkr gksaxsAxzh"edkyhu l=k esa 13 o"kZ ls vf/d vk;q osQ yM+dksa dks cl lqfo/k ugha nh tk,xhA

13- jk"Vªh; cky Hkou ,d cPpksa dh laLFkk gS ftldh ifo=krk cuk;s j[kus gsrq ;gk¡ /weziku] e|iku] vU; u'khysinkFkks± dk lsou o£tr gSA

14- cky Hkou ls izLFkku osQ i'pkr~ vius xarO; LFkku ij igq¡pus ij] cl ls mrj dj cPpsa mlh txg [kM+sjgs] tc rd fd muosQ ekrk&firk ;k vfHkHkkod mUgsa ysus u vk,aA ekrk&firk ;k vfHkHkkod Hkh è;ku j[ksafd cl osQ vkus ls igys gh LVkWi ij bartkj djsaA fdlh vtuch ls ckr u djsa vkSj u gh fdlh osQ lkFktk,a ;k fyÝV ysaA

15- jk"Vªh; cky Hkou cPpksa dh lqj{kk gsrq iwjh lko/kuh ysrk gS ijUrq cPpksa dks Lo;a Hkh lroZQ jgus dhvko';drk gS blfy, ekrk&firk cPpsa dks bl lEcU/ esa vko';d funsZ'k nsaA

16- cPps osQ igpku i=k@cl dkMZ (jk"Vªh; cky Hkou }kjk tkjh) dh dbZ izfr;ka vius ikl j[ksaA dkMZ xqe gksusdh fLFkfr esa nwljk dkMZ iqjkus dkMZ dh izfr fn[kkus ij gh tkjh fd;k tk,xkA

ekrk&firk@vfHkHkkod izfr

NATIONAL BAL BHAVANKotla Road, New Delhi-110002

Membership Section

Registration No. .................... S. No. ...............................

Route No. ............................... Date : ...............................

Received with thanks from...............................................................................

Sum of Rupees ....................................................................................................

on account of .......................................................................................................

Membership Fee Rs. ................................. Activities

Identify Card Fee Rs. .................................

Bus Fee Rs. ................................. 1. ...............................................

Total Rs. ................................. 2. ...............................................

For (Director)

dksVyk jksM+] ubZ fnYyh-2 • Kotla Road New Delhi-2

nwjHkk"k : 23234701 • Phone : 23234701

Valid Upto31st March 2018

ukeName ..........................................................................

tUe frfFk vk;qDate of Birth .............................. Age .......................

irkAddress ......................................................................

irk.....................................................................................

nwjHkk"kPhone ...................................

funs'kd/Director

ia- la[;kReg. No. ....................

:V la[;kRoute No. .................

vuqns'k / INSTRUCTIONS

1. ;g i=k gLrkarj.kh; ugh gSA2. cky Hkou esa izos'k oS/ igpku i=k/kjh dks gh feysxkA3. ;fn igpku i=k [kks tkrk gS] rks vuqfyfi i=k 10/- (nl :i;s) tek djkus ij gh fn;k

tk;sxkA4. Ñi;k [kks;s gq;s i=k dks izkIrdrkZ] funs'kd osQ dk;kZy;] jk"Vªh; cky Hkou] dksVyk jksM+]

ubZ fnYyh&110002 esa tek djk;sA nwjHkk"k % 011-23216693, 23216691

funs'kd osQ vkns'kkuqlkj

1. This card is not transferable.2. Entry in Bal Bhavan is allowed only to the valid Identity Card Holders.3. If identity card is lost duplicate will be issued for 10/- (Rupees Ten).4. Finder may kindly deposit this card at Director's Office, National Bal

Bhavan, Kotla Road, New Delhi-110002. Phone : 011-23216693, 23216691

By Order Director