Passportsize Photograph with UNIFORM Full Name of RSL / RL Date of Birth Gender MaleFemale 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 SelectAlluri Sitharama RajuAnakapalliAnantapurAnnamayyaBapatlaChittoorDr. B. R. Ambedkar KonaseemaEast GodavariEluruGunturKakinadaKrishnaKurnoolNandyalNTRPalnaduParvathipuram ManyamPrakasamSri Potti Sriramulu NelloreSrikakulamSri Sathya SaiTirupatiVisakhapatnamVizianagaramWest GodavariYSR Pincode Occupation Type EmployedSelf EmployedUnEmployed Highest Educational Qualification SSCIntermediate / EquivalentDiplomaBachelor's DegreeMaster's DegreePh.D Organization Name Designation Years of Experience BSG UID Are you a Rover Scout LeaderRanger Leader District Association SelectAlluri Sitharama RajuAnakapalliAnantapurAnnamayyaBapatlaChittoorDr. B. R. Ambedkar KonaseemaEast GodavariEluruGunturKakinadaKrishnaKurnoolNandyalNTRPalnaduParvathipuram ManyamPrakasamSri Potti Sriramulu NelloreSrikakulamSri Sathya SaiTirupatiVisakhapatnamVizianagaramWest GodavariYSR Training Qualification BasicAdvanceHWBPre-ALTALTLT 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
