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HINDUSTAN SCOUTS AND GUIDES KARNATAKA

Recognized by Govt. of India (Ministry of Youth Affairs and Sports)


Affiliated with World Federation of Independent Scouts, Germany
SHQ: #74 Bengaluru Public School Doddakammanahalli, Bannerughatta main Road ,Bengaluru -560083
www.hsgkarnataka.com | Email:hsgkarnataka@gmail.com | Ph: 7353823679, 9900918658
Student Photo

STUDENT REGISTRATION FORM


HSG/KAR -

1. Student Name (In Block Letters): ___________________________________________________________________

2. Parents/Guardian Name: __________________________________________________________________________

3. Date of Birth: ___________________4. Blood Group: ___________________5. Class/Sec_____________________

6. School Name and Address: ________________________________________________________________________

__________________________________________________________________________________________________

7.Range :________________________Cluster ___________________________ District _________________________

8. Residential Address________________________________________________________________________________

__________________________________________________ Pin Code: _____________________________________

9. Telephone/Mobile: ______________________________ Aadhaar No: ___________________________________

10. E Mail : ________________________________________________________________________________________

Declaration:
1. I agree to adhere strictly to the rules and regulations of Hindustan Scouts and Guides Karnataka
2. I declare that I will pay a proactive role for the development of Hindustan Scouts and Guides in
the State of Karnataka.
3. I will participate in all the possible camps, training session and any other activities.

Signature and seal of Head of Institution


Signature of the student

Parents/Guardian signature
***************************************************************************************************
For office only

Received on______________________ Amount: _____________________Receipt no: __________________________

Bank: ________________________________________ Cheque No.____________________ Dated: -_______________

Registration No.____________________________________ Dated: -_________________________________________

State Chairman State / Secretary

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