KLE Academy of Higher Education & Research, Belagavi
Formerly known as KLE University
[Declared as Deemed-to-be-University u/s 3 of the UGC Act, 1956 vide Government of India Notification No.F.9.19/2000-U.3(A)]
Accredited 'A' Grade by NAAC (2nd Cycle) Placed in Category 'A' by MHRD (GoI)
Don't Use ( ' ) special characters in any field
College / Post / Department : -
Name of the Institution :
KLE Institute of Physiotherapy, Belagavi
Application for the Post of :-
Occupational Therapy
PERSONAL INFORMATION
Name of the Candidate:
Birth Date :
Religion :
[Select your Religion]
Hindu
Muslim
Christen
Jain
Buddist
Shikh
Parsis
Other
Caste :
Nationality :
CORRESPONDANCE ADDRESS
Address
City
Pincode
Distict
State
SELECT
Andaman and Nicobar Islands
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chhattisgarh
Dadra and Nagar Haveli
Daman and Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Lakshadweep
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Orissa
Puducherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
PERMANENT ADDRESS
Address
City
Pincode
Distict
State
SELECT
Andaman and Nicobar Islands
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chhattisgarh
Dadra and Nagar Haveli
Daman and Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Lakshadweep
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Orissa
Puducherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
CONTACT DETAILS
Std.No
Telephone.No
Email Address
Mobile Number
DETAILS OF QUALIFICATIONS
Education Qualification :-
Sl.No
Qualification
Name of Course
Name of the Institution
Name of the Board/University
Year of Passing
% of Marks obtained
1
SSLC / Matriculation / Equivalent Exam
2
PUC / 12th / Equivalent Exam
3
Under-Graduate (UG) Degree
4
Post-Graduate (PG) Degree
5
Doctor of Philosophy (Ph.d)
6
Others, if Any
EXPERIENCE
Sl.No
Name of the Institution
Date of Joining
(DD/MM/YYYY)
Date of Leaving
(DD/MM/YYYY)
Post Held
Last Salary Drawn
Reasons for Leaving
1
2
3
4
5
TEACHING EXPERIENCE
Total Teaching Experience at UG Level
Total Teaching Experience at PG Level
Total Teaching Experience
ANY OTHER INFORMATION
Any other relevant information
( distinctions conferred, ranks,medals,research paper presented etc
Details of Research / Innovations conducted
If selected, joining time required