Application Form – Entrance Examination 2025 Application Form – Entrance Examination 2025 (Bachelor of Physiotherapy & Bachelor of Occupational Therapy) 1. Personal Information Student Full Name Select Mr. Ms. Mrs. ▼ Father Name Mother Name Email Address * Date of Birth * Mobile Number * Alternate Contact No (Parent/Guardian) Residential Address Locality City District State Pin Code • Category General SC ST Other • Nationality — Select — Indian Foreign NRI • PwD (Person with Disability) — Select — Yes No 2. Course Selection Please select the course(s) you are applying for: — Select — Bachelor of Physiotherapy (BPT) Bachelor of Occupational Therapy (BOT) 3. Academic Qualifications Examination Passed Board/University Year of Passing Percentage/Grade 10th (SSLC) 12th (PUC/Equivalent) 4.Entrance Examination Details If applicable, please provide your entrance examination details: • NEET UG Score: • State Entrance Exam Name: • State Entrance Exam Score: 5. Payment Details Application Fee: ₹500 Payment Method UPI Online Transfer Physiotherapy Account Info Physiotherapy Account Details Account Name: SHANTHA COLLEGE OF PHYSIOTHERAPY Account Number: 120001753520 Branch Name: PERESANDRA BRANCH IFSC Code: CNRB0001293 Scanned Photo: Allied Health Science Account Info Allied Health Science Account Details Account Name: SHANTHA COLLEGE OF ALLIED HEALTH SCIENCE Account Number: 1293201000439 Branch Name: PERESANDRA BRANCH IFSC Code: CNRB0001293 Scanned Photo: • Transaction ID/Reference Number * Upload the payment receipt along with the UTR number * Select Image 6. Document Uploads (PDF/JPEG) 10th Marks Card * Select Image 12th Marks Card * Select Image NEET Scorecard (if applicable) Select Image State Entrance Exam Scorecard (if applicable) Select Image Recent Passport-size Photograph * Select Image Scanned Signature * Select Image Government ID Proof (Aadhaar/Passport/etc.) Select Image PwD Certificate (if applicable) Select Image Payment Receipt / Screenshot * Select Image 7. Referral — Select — Student Referral Faculty Referral Name 8.Declaration I hereby declare that the information provided above is true and correct to the best of my knowledge. I understand that false or misleading information may result in the cancellation of my application.
