Anda di halaman 1dari 11

My SEWA Promise Form

Dear Student,
SEWA is the first step to prepare you for life. It is a voluntary project experience. You have
to complete My SEWA Promise Form and obtain prior approval for the project/activity.
Selection of a SEWA Activity, development, implementation of the proposal and evaluation
of the activity is the responsibility of each student. Signature of the Parent indicates review
and approval of this proposal.

Student’s Name: ________________________________ Class & Section: ______________

Brief Description of the Activity:

Duration (Days and Time): ______________________ Estimated Hours:______________

Name of Mentor Teacher: ____________________________________________

Student Signature:____________________________ Date: _______________________

Parent Signature :____________________________ Date: _______________________

For further details please refer to the link


http://cbseacademic.nic.in/web_material/Circulars/2018/11_Circular_2018.pdf
SEWA Hourly Schedule(illustrative)
Hour Count Date and Day Proposed Activity Plan

Hour 1

Hour 2

Hour 3

Hour 4

Hour 5

Hour 6

Hour 7

Hour 8

Hour 9

Hour 10
Hour Count Date and Day Proposed Activity Plan

Hour 11

Hour 12

Hour 13

Hour 14

Hour 15

Hour 16

Hour 17

Hour 18

Hour 19

Hour 20
Hour Count Date and Day Proposed Activity Plan

Hour 21

Hour 22

Hour 23

Hour 24

Hour 25

Hour 26

Hour 27

Hour 28

Hour 29

Hour 30
Hour Count Date and Day Proposed Activity Plan

Hour 31

Hour 32

Hour 33

Hour 34

Hour 35

Hour 36

Hour 37

Hour 38

Hour 39

Hour 40
SEWA Hour Log(illustrative)

STUDENT NAME: ___________________________________________

PROJECT: _______________________________________________

Date Activity Hours Mentor’s


Signature
STUDENT NAME :__________________________

Date Activity Hours Mentor’s


Signature
STUDENT NAME :__________________________

Date Activity Hours Mentor’s


Signature
Mentor’s Observation

Attendance: _ ___________________________ __________________________

Involvement: ___________________________ __________________________

Regularity: ___________________________ __________________________

Commitment: ___________________________ __________________________

Additional Comments: ___________________________ _____________________

________________________________________ __________________________

___________________________ ________________________________________

The activity project was (circle appropriate response):

Satisfactorily Completed Not Satisfactorily Completed


_____________________ ______________________

Mentor’s Signature ___________________

Name ____________________________

Seal of School
SEWA Self Appraisal Form

My Name____________________________________________________________________

My Activity / Project___________________________________________________________

My Commitment Towards the Project/ Activity

____________________________________________________________________________

___________________________________________________________________________

This Activity/ Project has been a great learning experience because

___________________________________________________________________________

___________________________________________________________________________

I initially felt that the project could not have achieved its outcomes because

___________________________________________________________________________

___________________________________________________________________________

The project has definitely changed me as a person in terms of behaviour, attitude and life skills
because
___________________________________________________________________________

___________________________________________________________________________

The details of beneficiary(ies). Any significant comment received from them; please quote

___________________________________________________________________________

___________________________________________________________________________

The challenges I faced and the things I might do differently next time so as to improve?

___________________________________________________________________________

___________________________________________________________________________
HEALTH AND ACTIVITY RECORD
GENERAL INFORMATION

Aadhar Card no. of Student (optional)___________________________

NAME: .

ADMISSION NO.: DATE OF BIRTH: .

M F T _____ BLOOD GROUP: .

MOTHER’S NAME: .

YOB WEIGHT HEIGHT _______ BLOOD GROUP_____

AADHAR CARD NO. (optional) _____________________

FATHER’S NAME: .

YOB WEIGHT HEIGHT _______ BLOOD GROUP_____

AADHAR CARD NO. (optional) _____________________

FAMILY MONTHLY INCOME .

ADDRESS ___________________________________ ___________

PHONE NO. (M): .

CWSN, SPECIFY ______________________________________.

SIGNATURE OF PARENTS/ GUARDIAN DATE: