Online Registration Form

Registration Form

Phone no. of Parent/Guardian *

E-mail of Parent/Guardian *

Note: This phone no. and e-mail address is compulsory for future references and for login process. Duplicate e-mail address for registration is not allowed

Upload passport size photograph of the child (only .jpg or jpeg file) (Below 50 KB)

Personal Details of Student

Name of the Child *

Choose Date of birth *
.

Age as on 31/03/2025 *

Select Gender (Boy/ Girl/ Transgender) *

Aadhar Number

Select Blood Group

Name of the tribe

Select Disability Status (Yes/ No) *

Select Type of Disability and its Percentage

Native Language/ Mother Tongue

Have you passed Class 5 ? *

Class in which currently studying

Medium of Instruction

Name of the school attended

Select Reservation category under which admission of the child is sought (as per Admission Guidelines) *

ST Children
Children belonging to PVTG communities
Children belonging to DNT/NT/SNT community
Children who have lost their parents to LWE/insurgencies/Covid
Children of widows
Children of Divyang parent, others e.g. Land donor, orphan child etc
Land donor

Abbreviation :

1.EMRS-Eklavya Model Residential School
2.ST-Schedule Tribe
3.PVTG-Particularly Vulnerable Tribe Group
4.DNT-Denotified Tribes
5.NT-Nomadic Tribes
6.SNT-Semi-Nomadic Tribes
7.LWE-Left Wing Extremism
8.CES-Centre of Excellence for Sports

Personal Details of Parents/Guardian

Father’s Name

Mother’s Name

Name of Guardian

Address/Residential details of Parents/Guardian

Permanent resident of assam:*

Present Address *

Block:*

Police Station :*

Pincode:*

Select District:*

Select State:*

Permanent Address *

Block:*

Police Station :*

Pincode:*

Select District:*

Select State:*

Check this if Present Address and Permanent Address are the same.

Upload Address proof/Residential ID
(Ration card/Voter ID/Aadhar card/Driving License/PRC/Passport, etc.)
(only .pdf file) (Below 500 KB)

Occupation of Parents/Guardian

Father’s Occupation

Mother’s Occupation

Guardian's Occupation

Select Annual Income Slab * Click here if your annual income is 5 Lakhs or below 5 lakhs.

Choose School (for Admission)

Choose EMRS (School)-Preference wise :*

Choose District of exam centre :*

Dropout/Rusticated details of students

Are you a drop out of any of EMRSs? (Only for lateral entry) :*

Name of EMRS last studied :

Year of Drop out :

Reason for dropping out of EMRS :

Have you ever been rusticated from any School?:*

Name of School from where you were rusticated :

Year of Rustication :

Reason of Rustication :

Declaration

By clicking this checkbox, I hereby declare that the information submitted herein are true and correct. I understand that in the event of particulars or information given herein being found false or incorrect, candidature of my child is liable to be rejected or cancelled.