Full Name of the Student

Date of Birth

GenderMaleFemaleOthers

Class—Please choose an option—IIIIVVVIVIIVIII

Section

AADHAAR or Permanent Education Number (PEN)

Father's/Mother's Name

Permanent Home Address

PO/PS

District—Please choose an option—BishnupurChandelChurachandpurImphal EastImphal WestJiribamKakchingKamjongKangpokpiNoneyPherzawlSenapatiTamenglongTengnoupalThoubalUkhrul

PIN Code

Name of the School

Address of the School

Zonal Education Office

UDISE Code

Email ID

Parent's Mobile Number

Passport Photo UploadAllowed file types: JPG, JPEG, PNG. Maximum size: 2 MB.

Bonafide Certificate UploadAllowed file types: PDF, JPG, JPEG, PNG. Maximum size: 5 MB.

I declare that all the information furnished herein are true to the best of my knowledge and I will abide by the rules and regulations of the organising committee.