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University College Kuliyapitiya - Application Form: Post Applied For

This document is an application form for a position at University College Kuliyapitiya. It requests information such as the applicant's name, contact details, date of birth, citizenship status, educational background, professional qualifications, languages spoken, work experience, references, and a certification that the information provided is true. The form is to be signed by the applicant and forwarded by the head of the applicant's current institution if applicable.

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AD D
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Available Formats
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566 views

University College Kuliyapitiya - Application Form: Post Applied For

This document is an application form for a position at University College Kuliyapitiya. It requests information such as the applicant's name, contact details, date of birth, citizenship status, educational background, professional qualifications, languages spoken, work experience, references, and a certification that the information provided is true. The form is to be signed by the applicant and forwarded by the head of the applicant's current institution if applicable.

Uploaded by

AD D
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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University College Kuliyapitiya - Application Form

POST APPLIED FOR :


1. Name in full : [Underline Surname] Dr./Mr./Ms
[If registered as a student in a University under
any
other name. please indicate such name within
brackets]
2. Postal Address :
[Any change should be communicated
immediately]
3. Contact Details:
i. Telephone (residence)
ii. Mobile
iii. E-mail
4. Date of Birth and Age : [Please attach copy
of Birth Certificate]
5. Civil Status :
6. National Identity Card Number :
7. Whether a Citizen of Sri Lanka [State
whether by descent or by registration: if by
registration, give reference number and date
of certificate of
citizenship]
8. Educational Qualifications :
8.1 School Education
School/s Attended From To
i.
ii.
iii.
iv.
v.

8.2 University Education –Undergraduate and postgraduate


Name of the University Degree/Diploma Course Result From To
Followed Class
i.
ii.
iii.
iv.
v.
vi.
9. Professional Qualifications
i.
ii.
iii.
iv.

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University College Kuliyapitiya - Application Form

10. Academic distinctions, scholarships, Medals, Prizes etc. [Indicate the institution
from which such awards have been obtained - Please attach copies of all relevant
certificates]
Award Institution
1.
2.
3.
4.
11. Proficiency of Languages [Indicate the institution from which such awards have been
obtained - Please attach copies of all relevant certificates]
Language Highest Examination passed
1. Sinhala
2. Tamil
3. English
4. Other (Specify)
12. (a) Present Occupation and Salary Drawn
Institution Occupation Salary drawn

(b) Previous employments with dates


Institution Post From To Reasons for leaving
1.
2.
3.
4.
5.
6.
13. Administrative/Financial/any other relevant Experience, if any

14. Particulars of Bond Obligations to Higher Educational Institutions/Institutes if


any:
Institution Obligatory Service period Bond amount due
1.
2.
3.
4.

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University College Kuliyapitiya - Application Form

15. Commendations/Punishments during your career yes No


yes no
If yes, please provide details

16. Extra-Curricular Activities

17. Any other relevant particulars (Not included above)

18. Have you ever been convicted by a court of law? yes no


yes no

If yes please provide details

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University College Kuliyapitiya - Application Form

19. Names of two Referees [With address]

Name Address Telephone Number

1.

2.

20. I hereby certify that the particulars submitted by me in this application are true and
accurate. I am aware that 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 appointment.

……………………………… …………………………………………

Date Signature of Applicant

[TO BE COMPLETED BY THE HEAD OF THE INSTITUTE


WHERE APPLICABLE]

Director,
University College Kuliyapitiya.

Application forwarded. Please note that if selected, action will be taken to release
him/ her from service.

……………………………… …………………………………………

Date Signature of Head of Institution

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