Passportsize Photograph with UNIFORM Full Name of RSL / RL Date of Birth Gender Male Female Father / Guardian Name Mother's Name Mobile Number Whatsapp Number E-Mail ID Blood Group A+ A- B+ B- AB+ AB- O+ O- Emergency Contact Person Emergency Contact Number Residential Address State District Select Alluri Sitharama Raju Anakapalli Anantapur Annamayya Bapatla Chittoor Dr. B. R. Ambedkar Konaseema East Godavari Eluru Guntur Kakinada Krishna Kurnool Nandyal NTR Palnadu Parvathipuram Manyam Prakasam Sri Potti Sriramulu Nellore Srikakulam Sri Sathya Sai Tirupati Visakhapatnam Vizianagaram West Godavari YSR Pincode Occupation Type Employed Self Employed UnEmployed Highest Educational Qualification SSC Intermediate / Equivalent Diploma Bachelor's Degree Master's Degree Ph.D Organization Name Designation Years of Experience BSG UID Are you a Rover Scout Leader Ranger Leader District Association Select Alluri Sitharama Raju Anakapalli Anantapur Annamayya Bapatla Chittoor Dr. B. R. Ambedkar Konaseema East Godavari Eluru Guntur Kakinada Krishna Kurnool Nandyal NTR Palnadu Parvathipuram Manyam Prakasam Sri Potti Sriramulu Nellore Srikakulam Sri Sathya Sai Tirupati Visakhapatnam Vizianagaram West Godavari YSR Training Qualification Basic Advance HWB Pre-ALT ALT LT Certification Details Team / Crew Name No. of Members in your Team / Crew Declaration I hereby declare that the information given above and in the enclosed documents is true to the best of my knowledge and belief and nothing has been concealed therein. Submit
