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  • The Indian Association of Physiotherapists: Exam Form

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    Devanshi Upadhyay
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    This document contains an exam application form for the Indian Association of Physiotherapists. The form requests information such as the applicant's name, date of birth, address, contact details, education history, agreement to the association's constitution and ethical principles, payment details, and a checklist of required documents to submit with the application.

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    imap_exam_form_871004258

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    This document contains an exam application form for the Indian Association of Physiotherapists. The form requests information such as the applicant's name, date of birth, address, contact details, education history, agreement to the association's constitution and ethical principles, payment details, and a checklist of required documents to submit with the application.

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    43 views1 page

    The Indian Association of Physiotherapists: Exam Form

    Uploaded by

    Devanshi Upadhyay
    This document contains an exam application form for the Indian Association of Physiotherapists. The form requests information such as the applicant's name, date of birth, address, contact details, education history, agreement to the association's constitution and ethical principles, payment details, and a checklist of required documents to submit with the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    THE INDIAN ASSOCIATION OF PHYSIOTHERAPISTS

    EXAM FORM PASSPORT SIZE


    (To be filled in Block Letters only) PHOTO

    Name .....................................................................................................................................................................

    ............................................................................................................................................ Sex : (M) / (F)

    Nationality ................................................ Date of Birth : ............... / ............... / ............... (DD/MM/YY)

    Address .....................................................................................................................................................................

    .....................................................................................................................................................................

    .............................................................................................................................. PIN ...............................

    Mobile No. ........................................... Email : .............................................................................................................

    Preference of Exam Centre : ............................................................................................................................................

    (A) PRE - PROFESSIONAL

    School Name of Board Year of Passing % of Mark Obtained

    (B) PROFESSIONAL

    College Name of University Year of Passing % of Mark Obtained

    I agree by the Constitution and Bye - laws of the Association and uphold its Ethical principles.
    I am remitted Rs. 1500/- (Fifteen Hundred Rupees) as Exam Fees.
    D.D. No. .................................. Dated .................. of Bank ................................................................................................................
    All payment by draft in favour of “Indian Association of Physiotherapist”, payable at “INDORE” addressed to
    Dr. Sanjeev Tomar, 365, Shiv Colony, Sec. 6, Hiran Magri, Udaipur, - 313002 (Rajsasthan) INDIA
    E-mail : sanjeevtomar@hotmail.com, sanjeevtomar@rediffmail.com
    Minium Criteria for sending Application : Xerox copy of 10th, 12th, B. P. T. Marksheet, Course Completion, Internship Completion,
    Degree & Provisional Degree.

    Date : ........ / ........ / ................ (DD / MM / YYYY) Signature of the Applicant

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