Form No- XXViSHQ No-.............. RHQ No-............
THE BHARAT SCOUTS AND GUIDES, NATIONAL HEADQUARTERS
16, MAHATMA GANDHI MARG, I.P. ESTATE, NEW DELHI- 110002
REGISTRATION FORM FOR GOLDEN ARROW BADGE
Name of the State TAMIL NADU
1. Name of the Cub/Bulbul D. ASWIKUMAR ………………………………………………………………………
( in capital letters )
2. Father’s Name MR. SURESH BABU . V Photograph in
( in capital letters ) uniform
3. Mother’s Name.… MRS. SATHYA PRIYA . S ………………………………………..
( in capital letters )
4. Home Address: NO.37.NALLA THAMBI STREET, TRIPLICANE, CHENNAI – 600005….....
..................................................................................................................................................
Distt CHENNAI………..State TAMIL NADU…………………..PinCode 600005.
Contact No- 9841560966…. Email Id of Parent-……………………………………………………………………………..
5. Date of Birth ( attach Birth Certificate issued by Head of Institution)
1 2 0 9 2 0 1 2
6. Aadhar No…528765752556………………………………………………
7. Name of the Unit and Address… SUBASH SCOUT GROUP …………………………………………..……………
( in capital letters) THE HINDU SENIOR SECONDARY SCHOOL, TRIPLICANE, CHENNAI. PIN 600005.…………
8. Date of Joining Cub/Bulbul 0 9 0 6 2 0 1 8
9. Date of Completion of Pravesh 0 7 1 0 2 0 1 8
10. Date of Investiture 1 4 1 0 2 0 1 8
11. Date of Completion of Pratham Charan/Komal Pankh 0 6 0 2 2 0 1 9
12. Date of Completion of Dwitiya Charan/Rajat Pankh 1 2 0 7 2 0 1 9
13. Date of Completion of Tritiya Charan/Swarna Pankh 2 4 0 7 2 0 2 0
14. (i) Chaturtha Charan/Heerak Pankh Re-testing camp held at
Venue From To
(ii) Date of Completion of Chaturtha Charan/Heerak Pankh D D M M Y Y Y Y
(iii) Chaturtha Charan/Heerak Pankh Certificate No………………………………………Date……………………………..
15. Details of Cub/Bulbul Proficiency Badge earned (in capital letter )
Sl No Group Name of Badge Date of Passing Name of Examiner
01 Character COLLECTOR 07/12/2020 A. ANNALAKSHMI
02 Physical Health TEAM PLAYER 15/03/2020 V. ANANTHI
03 Handicraft ARTIST 04/04/2021 UMA DEVI
04 Service FIRST AIDER 03/07/2021 LATHA
05 Conservation &Technology HERITAGE 01/10/2021 SHANTHA DEVI
06 From any group OBSERVER 24/07/2020 SAKARA PANDY
Date………………………………….. (Signature of Cub/Bulbul)
Certified that the information given above is correct as per the Unit records.
Date
Signature of Unit Leader
Name of Unit Leader N. KUMAR
Scouting/Guiding Qualification ADVANCED CUB MASTER
Warrant No. 77/11/CM/18 _Valid upto 05/09/2021
Certified that all information given by the unit is correct and District Association has conducted Test of
Tritiya Charan/Swarna Pankh and Proficiency Badges.
Signature Signature Signature
District Commissioner (S/G) District Secretary District Organising Commissioner(S/G)
District Association.....................................
Date........................... Date........................... Date...........................
The above information are checked and found correct as per the records and his/her application is
recommended for the Golden Arrow Award
Signature
State Organising Commissioner (Scout/Guide) State Secretary
Date ……………………………… Date ………………………………
_ _
(For use at the National Headquarters / Regional Headquarters)
Date of receipt of above information ………………………………………………………..……….is examined and found eligible as per
APRO part II/III and recommended to issue Golden Arrow Award Certificate & Badge.
Form Checked by Signature of Asst. Director
Name: ………………………………….
Signature……………………………………… Region………………………………….
Name …………………………………………….
Designation ………………………………….. Signature of Dy. Director BP/GP
