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S Chol or Ship Application A

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INSTITUTE OF CERTIFIED MANAGEMENT ACCOUNTANTS OF SRI LANKA

SCHOLARSHIP APPLICATION

PERSONAL DATA

1. Name with Initials:

2. Address:

3. Registration No: A
4. Educational Qualification:
(Indicate only the highest
examination passed & the
year of exam)

5. Professional
Qualification including
part qualifications &
year of exam:

CATEGORY OF SCHOLARSHIP
6. Category of the Scholarship applied for :

EDUCATIONAL QUALIFICATIONS

7. Performance at G.C.E. O/L Examination 8. Performance at G.C.E. A/L Examination


Year Index No Year Index No

Subject Grading Subject Grading

9. Performance at University Examinations:

University:

Examination:

1
Year Year
Subject Grading Subject Grading

Year Year
Subject Grading Subject Grading

Year of Completion:
Level of Performance:

PROFESSIONAL QUALIFICATION
10. Part Qualifications Obtained:

Qualification Stage/Part Subject Grade Year

11. Membership of Professional Institutes:


Institute Membership Year Admitted

2
SPECIAL ACHIEVMENTS
12.

EMPLOYMENT
13. Designation:
14. Employer:
15. Employer’s Address:
16. Brief Description of Present Duties:
(Describe in 15 to 20 words)

17.
Position Held Employer From To

18. Details of Past Experience (Describe in 40 to 50 words)

DECLARATION

19. I hereby certify that the information given by me in this application is true and correct. Photocopies of all
relevant certificates / results sheets are attached.

Date ………… …… …..…………………


Signature of Applicant
Official Stamp

ATTESTATION

I certify that the above named…………………………………………year student of …………………………….is


following a ………………year course of study in ……………………………………………………………………
I recommend this applicant for one of the Scholarships for Undergraduates.

Date ………… ………………………


Signature of Attestor
Official Stamp
Name of Attestor:
Designation:
Department:
University:
Address:

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