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HINDUSTAN SCOUTS AND GUIDES - KARNATAKA

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


Affiliated World Federation of Independent Scouting, Germany
SHQ: #74 Bengaluru Public School Doddakammanahalli, Bannerughatta main Road ,Bengaluru -560083
www.hsgkarnataka.com | Email:hsgkarnataka@gmail.com | Ph: 94800092426

STUDENT REGISTRATION FORM


HSG/KAR -

1. Students Name (In Block Letters): _________________________________________________________________


2. Parents/Guardian Name: _________________________________________________________________________
3. Date of Birth: ____________________4. Blood Group: ________________5. Course and year ________________
6. College Name and Address: ______________________________________________________________________
_________________________________________________________________________________________________
7. Residential Address______________________________________________________________________________
____________________________________________________8. Pin Code: __________________________________
9. Telephone/Mobile: _________________________________10.Email: _____________________________________
11. Aadhar No: ____________________________________________________________________________________

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.
2. I will participate in all the possible camps, training session and any other activities.

Signature of the student

Parents/Guardian signature Signature and seal of head of institution

***************************************For office only **************************************

Received on______________________ Amount: _____________________Receipt no: ____________________

Bank: ___________________________Cheque No.____________________ Dated: -______________________

Registration No.____________________________________ Dated: -___________________________________

State Chairman State Secretary

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