The Bharat Scouts and Guides, National Headquarters

NOMINATION FORM FOR THE BSG OUTSTANDING SCOUTS / GUIDES AWARD

Note: * fields are mandatory to be filled compulsory and fill the form in capital letters.
BSG UID NO

Event Name THE BSG OUTSTANDING SCOUTS / GUIDES AWARD

*Name of the Participant (in

capital)
*Fathers Name
*Mothers Name
*State (Scouting State)
*Residential Address
(District and State are to be
your Geographical identity )
Town : *District :
*State: *Pin Code:
Personal Contact *Mobile : +91 -
WhatsApp No : +91 -
Tel. No : ( )-

Name of the Scout/Guide

Unit with address
*E-Mail ID
*Date of Birth DD / MM / YYYY Blood Group
Educational Qualification
Experience in
Scouting/Guiding
Qualification in
Scouting/Guiding
 The attached A. Non-Scouting Component – B. Scouting / Guiding Component –
Academic Performance/ Accomplishments as a Scout/ Guide
documents Institutional and Community Service
o A.1 o B.1
o A.2 o B.2
o A.3 o B.3
o A.4 o B.4
o A.5 o B.5

Date Signature of the applicant

Certified that the information given above is correct as per the Vidyalaya records

Signature of the Unit Leader (S/G) Signature of the Principal

Date: Date:

Signature of the ASOC (S/G) Seal & Signature of the Deputy Divisional / Divisional Commissioner
Date: Date:

Seal & Signature of the State Organizing Commissioner (S/G) Seal & Signature of the State Secretary
Date: Date: