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EMRSET APPLICATION FORM FOR ADMISSION IN CLASS VI (2022-23)
EKLAVYA MODEL RESIDENTIAL SCHOOL
Chikim Village, Moreh, Tengnoupal District
(Under Ministry of Tribal Affairs, Government of India)
Candidate Name
Date of Birth
Age
Gender
Male
Female
Others
Identification Mark
Father Name
Occupation
Mother Name
Occupation
Legal Guardian Name
Occupation
Total Annual Income Of The Parents
Permanent Address
P.O
P.S
Sub-Division
Pin Code
Mobile No.
Name Of Tribe
Aadhaar No.
Name Brother/Sister Studying in EMRS
Select
Yes
No
If Yes, How Many?
Select
1
2
3
4
Details Of Schooling at Present :
Name Of The School
Address Of School
Class in which Candidate is studying
Required Documents
Student Passport Photo *
(Allow file type PNG,JPG,PDF and JPEG only.
Image size below 2MB.)
Residential/Domicile Certificate
(Allow file type PNG,JPG,PDF and JPEG only.
Image size below 2MB.)
ST Certificate
(Allow file type PNG,JPG,PDF and JPEG only.
Image size below 2MB.)
Birth Certificate/Aadhaar Card *
(Allow file type PNG,JPG,PDF and JPEG only.
Image size below 2MB.)
Income Certificate (Original)
(Allow file type PNG,JPG,PDF and JPEG only.
Image size below 2MB.)
I certified that the information given above is true to the best of my knowledge and belief. In case any of the information given above is found incorrect, I will abide by the decision of the EMRS
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