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Academic Programme Selection


Month of Entry

Year of Entry

Personal details


Full Name

Name with initials

Date of Birth


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)

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Emergency contact details

Person to be contacted


Telephone number