RAJYAPURASKAR REGISTRATION FORM - YADGIRI

RAJYAPURASKAR REGISTRATION FORM - YADGIRI

THE BHARAT SCOUTS AND GUDIES, KARNATAKA
RAJYAPURASKAR REGISTRATION FORM
(YADGIRI DISTRICT)
District Association Name *
N/A

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Upload Your Passport Size Photo in Scout/Guide Unifrom *
N/A
Upload file Capture image using webcam
Your Registered BSG UID *
N/A

Type only your valid BSG UID which you have registered with OYMS portal of the National Headquarters www.bsgindia.org
Aadhaar Number *
N/A
Name of the Applicant
N/A

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Title Required FULL NAME

Full Name in CAPITAL LETTERS; No Special Characters except DOT(.) and Space
Fathers Name
N/A

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Title Required FULL NAME
Mother's Name
N/A

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Title FULL NAME
Section *
N/A

SCOUT
GUIDE
School / College / Institution Name you are Studying now *
N/A
Class / Degree you are studying NOW *
N/A
Email *
N/A
Phone *
N/A
Residential Address
N/A

Required
Street Address Required
Address Line 2 City State/Region/Province Required
Postal / Zip Code

India
Country

Type your Complete address with Door Number, Street Name, Apartment Name, Landmark etc to get the proper communications which are sent through post/courier.
UNIT LEADERS DETAILS

Check the Correct and Complete details with your Unit Leader who will sign this application and fill this application.
Unit Name of your Scout / Guide Group *
N/A

Type your Unit name in English with CAPITAL LETTERS Only
Name of the Unit Leader (Scout Master / Guide Captain )
N/A

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Title Required Full Name
Warrant Number of the Unit Leader (Scout Master / Guide Captain) *
N/A
Date of Issue of the WARRANT *
N/A

dd-MMM-yyyy
Date of WARRANT VALIDITY
N/A

dd-MMM-yyyy
Scouting/ Guiding Qualification of Unit Leader *
N/A

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Training Certificate Number *
N/A
Date of Training Certificate Issued *
N/A

dd-MMM-yyyy
Unit Address
N/A

Street Address
Address Line 2 City State/Region/Province
Postal / Zip Code

India
Country
Unit Renewal Details

Check with your Unit Leaders / School before registering for the Correct Details
Unit Charter Number *
N/A
Date of Issue of Charter
N/A

dd-MMM-yyyy
Unit Renewal Receipt *
N/A
Date of Unit Renewal Paid Receipt Date *
N/A

dd-MMM-yyyy
Details of the Applicant

Please fill the correct dates as the records.
Date of Birth *
N/A

dd-MMM-yyyy
Upload the Date of Birth Certificate (in JPG, PNG, JPEG format only)
N/A
Upload file Capture image using webcam
Date of Joining the Unit *
N/A

dd-MMM-yyyy
Date of Completing Pravesh *
N/A

dd-MMM-yyyy
Date of Investiture *
N/A

dd-MMM-yyyy

Investiture Ceremony Date should be after the Date of Completing the Pravesh
Date of Completing Pratham Sopan *
N/A

dd-MMM-yyyy
Date of Completing Dwitiya Sopan *
N/A

dd-MMM-yyyy
Date of Completing Tritiya Sopan *
N/A

dd-MMM-yyyy
Tritiya Sopan Testing Camp held at *
N/A
Tritiya Sopan Camp Date FROM *
N/A

dd-MMM-yyyy
Tritiya Sopan Camp Date TO *
N/A

dd-MMM-yyyy
Tritiya Sopan Certificate Number *
N/A
Upload your Tritiya Sopan Certificate
N/A
Upload file Capture image using webcam
Date of Tritiya Sopan Certificate Issued *
N/A

dd-MMM-yyyy
Details of proficiency Badge you have earned
Dwitiya Sopan Level
Name of the Proficiency Badge 1 for Dwitiya Sopan *
N/A

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Date of Passing the Proficiency Badge 1 for Dwitiya Sopan *
N/A

dd-MMM-yyyy
Name of the Examiner of Proficiency Badge 1 for Dwitiya Sopan *
N/A
Name of the Proficiency Badge 2 for Dwitiya Sopan *
N/A

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Date of Passing the Proficiency Badge 2 for Dwitiya Sopan *
N/A

dd-MMM-yyyy
Name of the Examiner of Proficiency Badge 2 for Dwitiya Sopan *
N/A
Tritiya Sopan Level
Name of the Proficiency Badge 1 for Tritiya Sopan *
N/A

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Date of Passing the Proficiency Badge 1 for Tritiya Sopan *
N/A

dd-MMM-yyyy
Name of the Examiner of Proficiency Badge 1 for Tritiya Sopan *
N/A
Name of the Proficiency Badge 2 for Tritiya Sopan (GROUP A) *
N/A

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Date of Passing the Proficiency Badge 2 for Tritiya Sopan (GROUP A) *
N/A

dd-MMM-yyyy
Name of the Examiner of Proficiency Badge 2 for Tritiya Sopan (GROUP A) *
N/A
Name of the Proficiency Badge 3 for Tritiya Sopan (GROUP B) *
N/A

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Date of Passing the Proficiency Badge 3 for Tritiya Sopan (GROUP B) *
N/A

dd-MMM-yyyy
Name of the Examiner of Proficiency Badge 3 for Tritiya Sopan (GROUP B) *
N/A
Rajya Puraskar Level Proficiency Badges
Name of the Proficiency Badge for Rajya Puraskar *
N/A

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Date of Passing the Ambulance for Rajya Puraskar *
N/A

dd-MMM-yyyy
Name of the Examiner of Ambulance for Rajya Puraskar *
N/A
Name of the Proficiency Badge 1 for Rajya Puraskar (GROUP A) *
N/A

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Date of Passing the Proficiency Badge 1 for Rajya Puraskar (GROUP A) *
N/A

dd-MMM-yyyy
Name of the Examiner of Proficiency Badge 1 for Rajya Puraskar (GROUP A) *
N/A
Name of the Proficiency Badge 2 for Rajya Puraskar (GROUP A) *
N/A

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Date of Passing the Proficiency Badge 2 for Rajya Puraskar (GROUP A) *
N/A

dd-MMM-yyyy
Name of the Examiner of Proficiency Badge 2 for Rajya Puraskar (GROUP A) *
N/A
Name of the Proficiency Badge 3 for Rajya Puraskar (GROUP A) *
N/A

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Date of Passing the Proficiency Badge 3 for Rajya Puraskar (GROUP A) *
N/A

dd-MMM-yyyy
Name of the Examiner of Proficiency Badge 3 for Rajya Puraskar (GROUP A) *
N/A
Name of the Proficiency Badge 1 for Rajya Puraskar (GROUP B) *
N/A

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Date of Passing the Proficiency Badge 1 for Rajya Puraskar (GROUP B) *
N/A

dd-MMM-yyyy
Name of the Examiner of Proficiency Badge 1 for Rajya Puraskar (GROUP B) *
N/A
Name of the Proficiency Badge 2 for Rajya Puraskar (GROUP B) *
N/A

-Select-
Date of Passing the Proficiency Badge 2 for Rajya Puraskar (GROUP B) *
N/A

dd-MMM-yyyy
Name of the Examiner of Proficiency Badge 2 for Rajya Puraskar (GROUP B) *
N/A
Signature of the Applicant
N/A

E-Signature Field
Clear