Acceptance Form to conduct Audit of Sanitation Facility being built in Schools under Swachh Bharat Abhiyan on pro-bono basis

Acceptance Form to conduct Audit of Sanitation Facility being built in Schools under Swachh Bharat Abhiyan on pro-bono basis Hon'ble Prime Minister, Shri Narendra Modi nominated the Institute of Chartered Accountants of India (ICAI) for the Swachh Bharat Abhiyan to take forward this campaign. The members & students of ICAI spread across the country need to play a vital role in taking this initiative of the Prime Minister forward and make Swachh Bharat Abhiyan a resounding success. ICAI is committed to be truly a Partner in Nation building. With this noble thought in mind, I as part of my Social and Professional responsibility commit myself to the cause to nation with the following information and pledge. I am sure my contribution will help towards making my Country neat and clean. Note: Member submitting this Form must hold the Certificate of Practice from the Institute. * Mandatory Personal Information Membership No. (MRN) *   Name *                                                 Date of Birth *                         Address *                                                   Village   Taluka/Panchayat   Block   District *                                               State *                                       Pin-Code *   Phone No. (Land Line)   Phone No. * (Mobile No.)   E-mail *   I accept assignment within radius of: * within 50 KM 50-100 KM 100-200 KM 200 KM and above   I, as a member of ICAI and holding Certificate of Practice, do hereby pledge my professional services on pro bono basis (and without reimbursement of out-of-pocket expenses) to conduct audit of sanitation facility being built in schools by PSUs of Government of India under Swachh Bharat Abhiyan as a service to the Nation. I am aware that once I exercise my option, it cannot be withdrawn. These services though being given on pro-bono basis, the assignment will be conducted as per all applicable Guidance Notes/Technical Guides and statutes. *   Date : ______________________                                                  Signature___________________                                                                                                                  Name__________________                                                                                                          Mobile No.______________