केन्द्रीय विद्यालय संगठन राज्य, भारत स्काउट्स एवं
गाईड्स, जम्मु सम्भाग
KVS STATE BHARAT SCOUTS AND GUIDES, JAMMU-DIVISION
राज्य पुरस्कार परीक्षा
- 2013 हेतु
प्रार्थनापत्र
Application for
Rajya Puraskar (State Award) Test – 2013
[Please fill up
the details carefully, over - writing will not be accepted]
Photo in S/G Uniform attested by the
Principal / Group Leader or Unit Leader
|
01. Name of the Division: -
JAMMU
02. Name of the District: - …………………………………………………………………………
03. Name of the Vidyalaya: - …………………………………………………………………………
04. Name of the Group: - …………………………………………………………………………
05. Registration No. of the Group: - ………………………………………………….……………………
06. Charter No. :- ………………………………………………….………………………
07. Name of the Scout / Guide: - (In Eng.)………………………………………………………………..
(हिन्दी में)…………………
08. Father's Name: - …………………………………………………………………………..…..…………………………………………………
09. Mother’s Name:-…………………………………………………………………….……………………………………………………………...
10. Date of
Birth: - …………………. /…………………. /………………….
11. Date
of Joining the Unit: - …………………. /…………………. /………………….
12. Date of Completion of Pravesh: - …………………. /…………………. /………………….
13. Date
of Investiture: -
…………………. /…………………. /………………….
14. Date
of Pratham Sopan: - …………………. /………………….
/………………….
15. Date of Completion of Dwitiya Sopan: - …………………. /…………………. /………………….
16. Date of Completion of Tritiya Sopan: - …………………. /…………………. /………………….
Certificate
No: - ………………………………………………… & Date: -……… /…..…… /…………. (Attached the Copy)
17. Details
of Rajya Puraskar Proficiency Badges:-
Sr.No.
|
Name of
the Prof. Badge
|
Date of Passing
|
Examiner’s
name, Designation & Address
|
1.
|
|||
2.
|
|||
3.
|
|||
Gr.-A
|
|||
Gr.-B
|
Date of COH Resolution Recommendation: - ……………/…………../2013
Signature
of Father/Guardian
Signature of Scout/Guide
Date: - ………… /…………. /2013
Date: - ………… /………… /2013
Recommended the Scout/Guide
(name)…………………………………………for the Rajya Puraskar Test-2013.
Signature
of the Scout Master/Guide Captain
Name of the Scout Master/Guide
Captain:-……………………………………………………………………………………….. Scouting/Guiding Qualification
(Adv/HWB/ALT/LT)…………......…….…Certificate No.:……………………….… Date:…….…/……..../………... Warrant No. ………..………………..… Date of Validity:
…….…/……..../………...
Recommended
the Scout/Guide (name)………………………………………..for the Rajya Puraskar Test-2013.
Date: ………. /………/2013 Stamp District/Divisional Commissioner (S/G)
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