Youth Red Cross - Group Membership

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This form is required to be filled by Colleges / Institutes willing to register their students for the Youth Red Cross program.

Select your IRCS Branch *

College / Institute Name *

University Name *

College / Institute Address *

College / Institute Contact No. *

College / Institute E-mail *

No. of Male Students *

No. of Female Students *

Total Students *

Managing Authority Name *

Managing Authority Contact No. *

Principal / Dean Name *

Principal / Dean Contact No. *

Counsellor Name *

Counsellor Contact No. *

I understand, that the registration fees for the College/Instituion is Rs. 150/-

Required

I understand, that the registration fees for each Participant is Rs. 40/-

Required

Submit

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