Name of the Head of the Institute Tel- Office Tel- Residence Tel- Mobile Fax Number Email ID Website Action
Course Name Duration(years) Tuition Fee per year (Rs.) No. of Students Total Fee Receipt per year (Rs.) Action
Admission Fee Tuition Fee Exam Fee Activity Fee (Sports/Cultural) Library Fee
Sl.No. Facilities Available Action
I Ramp
II Lift
III Accessible Classroom
IV Accessible Toilet
Sl.No. Type of Facilities as prescribed in the respective syllabus Min Area (Sq.Ft) Yes/No No. of rooms alloted to the selected training programme
I Classroom with adequate furniture 300
II Multi-purpose hall with adequate furniture & equipment 500
III Principal / Coordinator’s room 150
IV Staff Room 200
V Separate laboratories for Psychology, ICT 300 (min.)
VI Playground for outdoor games 500 (min.)
VII Library 300
VIII Barrier free toilet (separate for Male & female) 100
IX Resource Room 300
Equipment Action
Sl.No. Type of Facilities Yes/No Numbers
I DVD player
II. Computer with Internet facility
III. Digital Camera
IV. Television
V. LCD projector with screen
VI. Biometric Attendance Recorder
VII. Printer
VIII. Scanner
IX. PhotoCopier
Sl.No. Category of Books/ References Quantity
I Special Education (specific title)
II. General Education (specific title)
III. Speech and Language (specific title)
IV. Audiology (specific title)
V. Psychology (specific title)
VI. Clinical Psychology (specific title)
VII. Rehabilitation Psychology (specific title)
VIII. Prosthetic and Orthotics (specific title)
IX. Teacher Education (specific title)
X. Educational Management (specific title)
XI. Journals (specific title)
XII. Educational Technology (specific title)
XIII. Any other
Sl.No. Particulars Input
I Own special School ( managed by your own management)
II. Memorandum of Understanding (MoU) with any local special school for practice teaching. Only applicable for University/National Institutes
III. Funded by State Government
IV. Name of Special School
V. Number of Children in Special School( Min. 60 CWSN with specific disability)
VI. Number of RCI Registered Special Teachers in School
Name of the Faculty Mobile No. Email Designation Academic Qualification Rehab Qualification Teaching Experience Date of Appointment Salary per month CRR No. Action
Sl.No. Facilities Availability Quantity Space in Sq.Ft. (wherever applicable)
I Classroom
II. Office Room
III. Principal Room
IV. Staff Room
V. Play Ground
VI. Toilets
VII. PT/OT Room
VIII. Audiology & Speech Therapy Unit
IX. Psychological Unit
X. Vocational Section
XI. Resource Room
XII. Laboratory
XIII. Audio Visual Room
Name of the Faculty Mobile No. Email Designation Adhar Card No. CRR No. Action
Sl.No. Type of Facilities Availability Quantity Space in Sq.Ft.
I Classroom with adequate furniture
II. Office Room
III. Principal Room
IV. Staff Room
V. Play Ground
VI. Barrier free Toilets
VII. Counseling Section
VIII. Laboratory
IX. Audio Visual Room
X. Computer Room
XI. Psychiatric Dept
XII. Neuro. Dept
XIII. Pediatric dept
XIV. Psychological Unit
XV. Multi-purpose hall with adequate furniture & equipment
XVI. Library
XVII. Resource Room
Name of Equipment & Apparatus Action
Sl.No. Type of Facilities Yes/No Units
I. Computer with Internet facility
II. Digital Camera
III. LCD Projector
IV. CCTV System
Sl.No. Facilities Available Quantity
I No. of relevant books in the field
II No. of professional journals (core journal)
III No. of Audio Visual & CDs
Sl.No. Patients Turnover Outdoor Patient (Monthly) Indoor Patient (Monthly)
I Total no. of patients (existing and new)
II No. of new patients
III No. of existing patients (follow up)
Sl.No. Description Yes/No Units
I. Psychotherapy
II. Behavior Therapy
III. Biofeedback
IV. Marital Therapy
V. Sex therapy
VI. Family Therapy
VII. Hypnosis
VIII. Counseling for special group (such as HIV/AIDs, Cancer, Alcohol/drug abused, Parents/ Caregivers, etc.)
IX. Group Therapy
X. Retraining/Remedial training/Rehabilitation
XI. Other (specify)
Source % (on the basis of monthly statistics) Action
Department Duration Action