Kendriya Vidyalaya Sangathan State Bharat Scouts & Guides
(APPLICATION FOR THE TRITIYA SOPAN SCOUT / GUIDE TEST - 2024)
(TO BE FILLED BY THE CANDIDATE IN HIS / HER OWN HANDWRITING IN CAPITAL LETTERS. OVERWRITING /
USE OF FLUID WILL NOT BE ACCEPTED)
01. NAME OF THE DIVISION -………………………………………. (Photo in
02. NAME OF THE DISTRICT -………………………………………. S/G Uniform
03. NAME OF THE VIDYALAYA -………………………………………. attested by
04. NAME OF THE SCOUT / GUIDE -………………………………………. the Principal
05. FATHER’S NAME -……………………………………….
06. MOTHER’S NAME -.............................................................
07. DATE OF BIRTH -……………………………………….
08. UID NO. - ………………………………………
09. DATE OF JOINING UNIT -……………………………………….
10. DATE OF PASSING PRAVESH -……………………………………….
11. DATE OF INVESTITURE -……………………………………….
12. DATE OF PASSING PRATHAM SOPAN -……………………………………….
13. DATE OF PASSING DWITIYA SOPAN -……………………………………….
14. HOME ADDRESS:
P.O. District State
Pin code Telephone/Mob. No.
E-mail ID _________________________________________
15. Name and address of Unit
_________________________________________ District
Charter No. Date of Issue Date of Validity
Signature of Parents Signature of Scout/Guide
_____________________
SCOUT / GUIDE (NAME)
(Page-2)
Details of the work done
Pratham Sopan
Troop/Company Service Project (as per APRO Part II/III)
a)
b) Service activity (as per APRO Part II/III)
i)
ii)
Dwitiya Sopan
i) Detail of Proficiency Badge earned for Dwitiya Sopan as per Sl. No. 10 / (x) of APRO II / III
S.No. Name of the Badge Date of passing Examiner’s name & Designation
1
ii) Details of service activity done as per Sl. No. 8 / (viii) of APRO II / III
Tritiya Sopan:
a) Swimming or Proficiency Badge as per Sl. No. 02 of APRO II / III
S.No. Name of the Badge Date of passing Examiner’s name & Designation
1
b) Name of the subject / topic taken for the talk in Troop meeting. (as per S.No.06 0f APRO II/ III)
c) Details of day hike on foot undertaken as per Sl. No. 07(b) of APRO II / III
Date of Hike Place Distance(km) Report submitted on
From To
(Page-3)
d) Details of Proficiency Badges earned for Tritiya Sopan done under Sl. No. 10 of APRO II / III
S.No. Name of the Badge Date of passing Examiner’s name & Designation
GROUP-A
GROUP-B
Note: - All relevant records, Log Books, Proficiency Books, DOB Certificate, Badge Examiner Certificates. Copy of
Pratham Sopan and Dwitiya Sopan, Certificates should be produced in the testing camp as and when demanded.
Date of COH Resolution / Recommendation……………………………Signature of Scout / Guide…………
Certified that the information given above is correct as per the Vidyalaya / Unit records and
verified byme. The Name of the Scout / Guide written in application form is also verified from School
Register.
Name of the Scout Master / Guide Captain …………………………………. Signature: ………………
Qualification in Scouting / Guiding………………Warrant No. ………………………Valid up to …………
Signature of the Principal / District Commissioner (S/G)
(Page - 4)
Kendriya Vidyalaya Sangathan State Bharat Scouts & Guides
( Division)
Date of Birth Certificate
(Over-writing / Cutting will not be accepted)
This is to certify that Master / Kumari ……………………………………………………………….
S/o / D/o ……………………………………...is a student of Kendriya Vidyalaya…........................................ …with
Admission Number , studying in class………………………in the year......................................... and his
/ her date of birth is (in figures) ……………………………… (in words)
………………………………………………………............. as per the Vidyalaya records.
Date: Office Seal Sig. of the Principal
COH
The COH of ………………………………. Scout Troop / Guide Company of KV
…………………………………………. met at (place) .................................................................................... at
(time)……………………….am/pm on (date) ……………………and resolved to recommend the Scout /
Guide………………………………………………for the Tritiya Sopan Test-2021.
Members Signature Sig. of the Chairman
1. (Name of the Chairman)
2. Date:
3.
4.
Signature of SM / GC Signature of the Principal / District Commissioner (S/G)
