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APPENDIX
FORM “A”
[See Regulation 4(1)]
Application for enrolment as a member of the Civil Defence Service
1. Name in full (in Block letters)
2. Father’s/ husband’s name.
3. Date of birth
4. Nationality
5. Permanent address
6. Occupation and present address
7. Name and address of present employer
8. Educational qualifications
9. Languages known (to read/ write/ speak)
10. Are you a member of the following?
(i) Defence Forces (Army/Navy/Air Force) or any of their reserves;
(ii) Territorial Army or any other auxiliary force of Defence services;
(iii) Civilian cadre of Armed Forces of the Union, subject to Naval, Army or Air Force
law, other than “Casual employees”;
(iv) Police Service;
(v) Fire Services.
11. Are you an ex-service person? If so, give particulars.
12. Do you belong to the National Volunteers Force? If so give particulars.
13. Have you any previous experience in Civil Defence Corps? If so, give particulars,
including date.
14. Have you any preference for any particular section of Civil Defence Corps? If so, state the
section.
15. Have you any special qualifications for enrolment in the section chosen by you? If so,
give details.
16. In case of preference for service in Mobile Columns or ambulance trains, are you prepared
to serve anywhere in India, should an emergency arise?
17. For how many hours and so what days of the week will you be available for Civil Defence
duty (for part-time volunteers only).
18. Do you have any conveyance (bicycle, motor car, motor cycle) etc?
19. Are you suffering from any communicable diseases? If so, give particulars.
20. Did you have small pox? If so, when
21. Have you been vaccinated? If so, when
22. Have you been inoculated for cholera/ typhoid/ T.B etc? If so, when
23. Do you know First Aid/ motor driving?
24. Signature of applicant.
22 CIVIL DEFENCE LEGISLATION IN INDIA
DECLARATION
1. I have read the “Civil Defence Regulations, 1968”.
2. As far as I know. I am physically fit to render efficient service as a member of the
Corps.
3. If my application is accepted, I am prepared to service as a whole-time/ part- time
member of the Corps, i.e., to undergo the appropriate training and, in the event of any
emergency occurring whilst I remain a member of the Corps, to carry out my
obligations a a member thereof.
4. I undertake:-
(i) to carry out my duties in the Civil Defence Corps in accordance with the
instructions and orders issued by the authorities concerned;
(ii) to return, when I cease to be a member of the Corps, any articles of uniforms,
badge or other personal equipment issued to me; and
(iii) to abide by the regulations of the Corps.
Signature of the applicant
Place:
Date:
This form duly completed should be submitted to:-
Name and address of Enrolling Authority--------------------------------------------------------
FOR OFFICIAL USE
Recommendations of the Head of Corps/ Staff officer concerned
Admitted to (Corps, etc.) and
Allotted to (post No. etc.)-----
Signature--------------------------------------------- Signature---------------------------------------
Designation----------------------------------------- Designation-------------------------------------
Date------------------------------------------------- Date---------------------------------------------
FORM –B
Form of Oath
[ See Regulation 5 ]
I,-----------------------------* son/ daughter/ wife of ----------------------------- swear/ solemnly
affirm that I will be faithful and bear, true allegiance to India and to the Constitution of India
as by law established, and that I will loyally carry out the duties entrusted to me ( so help me
God*)
(* To be deleted as necessary)
CIVIL DEFENCE LEGISLATION IN INDIA 23
FORM-C
Serial No.--------------------
[ See Regulation 7 ]
Membership Certificate
Government of ---------------------------( name of States )
CIVIL DEFENCE CORPS
1. Name in full.
2. Nationality
3. Age
4. Father’s/ husband’s name
5. Identification marks
6. Permanent address
7. Name of Civil Defence Corps in which employed
8. Assignment
9 Name and address of next of kin
10 Signature / thumb (left Hand) impression of the worker.
Date of issue Office Stamp of Signature and designation of
Issuing Authority Issuing Authority
FORM –D
Government
Civil Defence
RECORD OF
[ See Regulation 13 ]
1. Name
2. Father’s/ husband’s name
3. Nationality
4. Date of birth/ age
5. Identification marks
Signature of Civil Defence Controller
Or of any officer on his behalf
24 CIVIL DEFENCE LEGISLATION IN INDIA
Particulars of C.D. Corps/ Training etc.
Name of Assignment Identity From To Scale Pay Allow- Total Reason for
Service Card No ances termination of
assignment e.g.
transfer etc.
1 2 3 4 5 6 7 8 9 10
N.B.-
(a) A record in the proforma should be maintained in respect of all C.D. personnel.
(b) Particulars in col.(1) to (18) should be filled in as and when they occur, and
attested.
(c) This record should be kept in the custody of a responsible officer, not below the
rank of head of Corps.
of__________________________________( name of State )
Corps
SERVICE
6. Permanent address
7. Particulars of post held under Government, etc.
8. Name and address of employer
9. Name and address of next of kin.
10. Signature / thumb impression
Leave taken Personal equipment, Signature Signature of Remarks
_________________ uniform and of C.D. head of C.D.
Nature Period accoutrement workers Corps
of __________ __________________
leave From To Items Items
issued returned
and date and date
of issue of return
11 12 13 14 15 16 17 18
Items 1 to 10 at the top should be filled in at the time of enrolment.
[No. 10/2/66-DGCD (ii) (1)]
J.C. AGARWAL, Jt. Secy.
REGISTERED NO. D.221
THE GAZETTE OF INDIA
EXTRAORDINARY
PART II- Section 3 – sub- Section (1)
PUBLISHED BY AUTHORITY
No.68. NEW DELHI, WEDNESDAY, APRIL.7, 1971/ CHATRA 17, 1893
Separate paging in given to this Part in order that it may be filed
as a separate compilation
MINISTRY OF HOME AFFAIRS
NOTIFICATION
New Delhi, the 6th April, 1971
G.S.R.520.- In exercise of the powers conferred by section 9 of the Civil Defence Act, 1968
(27 of 1968), the Central Government hereby makes the following regulations to amend the
Civil Defence Regulations, 1968, namely:-
1. (1) These regulations may be called the Civil Defence (Amendment)
Regulations, 1971.
(2) They shall come into force on the date of their publication in the official
Gazette.
2. In the Civil Defence Regulations, 1968.-
(a) for regulation 7, the following regulation shall be substituted, namely :- “
7, Mmebership Certificate.
(1) Every person appointed to be a member of the Corps shall be issued a
certificate of membership in Form C.
(2) A person losing the certificate issued to him under sub- regulation (1),
shall report its loss forthwith to his immediate superior officer, who shall
make necessary enquiries, and shall after satisfying himself, and arrange
the issue of a duplicate certificate of the same.
(3) The cost of the aforesaid duplicate certificate as determined by the
issuing authority shall be borne by the person to whom the certificate of
membership was issued under sub- regulation (1)”.
(b) in the appendix, for the existing Form C, the following Form shall be
substituted, namely:-
“ As on reverse”
25
26 CIVIL DEFENCE LEGISLATION IN INDIA
FORM C
NO.
[See Regulation 7]
Membership Certificate
Government of -------------------------------------( name of the State)
CIVIL DEFENCE CORPS
1. Name in full
2. Nationality
3. Date of birth
4. Father’s/ Husband’s name
5. Identification marks
6. Permanent Address
7. Name of Civil Defence Corps
In which employed.
8. Assignment
9. Name and address of next of kin
10. Signature/ thumb impression of the
PHOTOGRAPH
person
Date of issue
Office stamp of
Issuing Authority.
Signature and designation of
Issuing Authority
[ No. 5/33/69-DGCD (CD)]
J.C.AGARWAL, Jt. Secy.

 

 

 

 

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