Give your Work Informations below: Name of Reporter: Email: Actual Report Date*: Work Location(City/District)*: Work State*: —Please choose an option—Andaman and Nicobar Islands (UT)Andhra PradeshArunachal PradeshAssamBiharChandigarh (UT)ChhattisgarhDadra and Nagar Haveli (UT)Daman and Diu (UT)Delhi (UT)GoaGujaratHaryanaHimachal PradeshJammu and KashmirJharkhandKarnatakaKeralaLadakhLakshadweep (UT)Madhya PradeshMaharashtraManipurMeghalayaMizoramNagalandOdishaPuducherry (UT)PunjabRajasthanSikkimTamil NaduTelanganaTripuraUttar PradeshUttarakhandWest Bengal Team Members Name*: (Separate each names by comma): What and how did you volunteer?* Total Number of beneficiaries*: Details of beneficiaries*:(eg. Daily wagers, people of slum area, travellers, particular community or so) Outcome or Remarks? Please add min 3 of your activity photos. Images should be clear action photos in landscape mode (Horizontal). Avoid selfies and file size should bebelow 4MB of JPEG, JPG or PNG. Image 1*: Image 2*: Image 3*: Image 4: Image 5*:
