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Application Form
IPost appliedIIDepartment
1.1Surname with initials
(in block capitals)1.2Name in full
(in block capitals)
(copy of the birth certificate should be attached)1.31.4Civil Status1.5Gender1.6NIC/Passport No.1.7Date of Issue of NIC/Passport
2.1Postal Address
2.2Telephone (Residence)
(Mandatory)2.3Mobile
(Mandatory)2.4Email Address
3.1Date of Birth YearMonthDate3.2Age as at the closing date of applicationYearsMonthsDays3.3Whether citizen of Sri Lanka by descend or registration
3.5If by registration give reference number and the date of certificate of citizenship
4Schools attended Name of the SchoolFromTo1.2.3.5Educational Qualifications5.1G.C.E. O/L ExaminationYearSubject Grade Subject Grade 1.
2.
3.
4.5.
6. 6.
7.
8.5.2G.C.E. A/L ExaminationYear SubjectGradeSubjectGrade1.
2.
3. 4.
5.
6. 6University Education Degree TitleUniversity/InstituteCourse DurationEffective DateClass or GradeCourses/subjects followed
(copies of the degree certificates/transcripts containing details requested under 6 should be attached)7Postgraduate QualificationsDegree TitleUniversity/InstituteCourse DurationEffective DateClass or GradeCourses/subjects followed
(copies of the degree certificates/transcripts containing details requested under 7 should be attached)8Highest Examination passed in Sinhala/Tamil with grade (indicate whether Degree/A.L/O.L/etc)
9Professional Memberships Membership type
(Co-operate /Associate etc)InstituteDate on which membership awarded(copies of the membership certificates should be attached)10Any other ͷ Distinctions, Scholarships, Medals, Prizes, etc. ͷ Distinctions, Scholarships, Medals, Prizes, etc.Institution
11Research & Publications, if any
12Past experience relevant to the post appliedDesignationName of the EmployerFromToDD MMYYDDMMYY(copies of the experience certificates should be attached)13Present employmentDesignationName of the EmployerDate of AppointmentSector (Government, Private, etc)Salary Drawn (State whether basic or consolidated(Copy of the appointment letter should be attached)14Particulars of bond obligations to Higher Educational Institutions/InstitutesName of the Institutions/InstituteObligatory periodAmount due in Rupees15Salary point expected from the University within the salary scale advertised and reasons to
establish your claimSalary expectedReasons
16Extra curricular activities
17Names and addresses of two persons to whom reference can be made1218I hereby certify that the particulars submitted by me in the application and its annexure are true and accurate. I am aware that if any of these particulars are found to be false or inaccurate, I am liable to be disqualified before selection and to be dismissed without any compensation if the inaccuracy is detected after the appointment.
... ..
Date Signature of the Applicant
19Recommendation by the Head of the Institution (Employees of Government Departments, HEIs, Corporations, etc)
I recommend the above application and agree/not agree to release the applicant in case he/she is selected for the post applied.
. .... ....
Date Name Signature of the Head of Institution
..
Official Stamp
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