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Academic Programme Selection

Course

Month of Entry

Year of Entry

Personal details

Title

Full Name

Name with initials

Date of Birth

Nationality

NIC / Passport number

Contact details

Postal Address

Mobile Phone number

Home Phone number

E-mail address

Educational Information

School Attended

G.C.E Ordinary Level results

G.C.E. Adavanced Level results

Other educational qualifications

Upload a scanned copies of your documents (Passport/NIC, O/L Certificate, A/L Certificate, Other educational certificates)

Max. size: 40.0 MB

Emergency contact details

Person to be contacted

Relationship

Telephone number