UNDERTAKING

(To be executed on non judicial stamp paper of denomination Rs. 100/- or above)

1. Upon my request, the Bhabha Atomic Research Centre, Government of India, have kindly agreed to afford me training facilities in (branch/faculty/discipline) -------------------------- 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 ____________________________________college/institution and residing at ____________________________________ 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 :________________________________ Witness 1) : ________________________________ (Signature) ________________________________ Name & Address) ________________________________

Date : ________________________________

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

DEED OF UNDERTAKING (To be executed on plain paper)

In consideration of my being allowed by _________________________________at

my request to undergo project training as part of my education curriculum at

___________________________for________________course,I______________________

____________________s/o_______________________________resident of____________

________________ __________________________________ 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___________________________________________________

Countersignature of Parent

GAZETTED OFFICER’S CERTIFICATE

This is to CERTIFIED that *Dr/Shri/Smt/Kum _________________________________________

son/daughter/wife of 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

(Government Gazetted Officer only)

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

e) I shall at all times, conform to the rules and regulations of the Research Centre as may be prescribed form time to time

f) I shall at all times observe the health safety precautions as may be prescribed for entry into the plant/place of work.

g) I shall be liable for any loss or damage to the property of BARC caused due to my carelessness or negligence.

h) 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 ________________________

________________________________________________________________________ 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

1. Acceptance Letter from BARC

2. Bio-data Form

a. Photo Attested by college authority with stamp

b. Certificate Attested by college authority with stamp

3. Undertaking/Declaration duly signed by

a. Student

b. Two witnesses – other than blood relation

4. Deed of undertaking signed by

a. Student

b. Two witnesses – other than blood relation

c. Parent

5. Duly completed Information Sheet signed by college authority with seal

6. Character Certificate from Gazetted Officer other than from college.

7. Zerox of College Identity Card attested by College Authority with seal.

Please Note : Applicant(s)/representative may drop the set of documents, stapled together & placed in envelope, in the box kept for this purpose at the Training School Premises near the ‘B’ wing entrance 1. Applicants who have applied in a group should also submit forms in a group. 2. Intimation letter(s) will be issued between 10:30 to 12:00 hrs. only on Mondays

(for applications dropped from Tuesday to Friday of the previous week) and on Tuesdays (for applications dropped from Saturday to Monday).

Signature of Students