INSTITTUE OF TECHNOLOGY
INSTITUTE OF TECHNOLOGY
UNIVERSITY OF MORATUWA, SRI LANKA
APPLICATION FOR EXAMINATION
First/ Second Year Repeat Examination 2019/2020
1. i. Name of Course : ................................................................................................................
ii. Field of Specialization : .................................................................................................................
2. Name of Examination : .................................................................................................................
3. Name of Candidate :
(Please write name as appearing in student Record Book)
i. Last Name : ............................................................................................................................
ii. Other Names : ............................................................................................................................
iii. Name with Initials Mr./Miss/Mrs. : ........................................
4. Contact Address & Tele No : ..............................................................................................................................................................................................................................................................................................................................................................
5. Permanent Address and Telephone No :
..............................................................................................................................................................................................................................................................................................................................................................
6. Year of Study : ............................................................ 7. Admission No : ................................................
8. State whether appearing for :
i. Whole Examination for the first time :..............................................................................
ii. Whole Examination as a repeat candidate :..............................................................................
iii. Only referred subject/s :..............................................................................
9. State the subjects for which application is made at this Examination:
|S/N |Subject Code No |Name of Subject |Lecturer’s Initial |
| | | | |
|i. |................... |..........................................................................................................|....................|
| | |.......... | |
|ii. |................... | | |
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|iii. |................... |.......... | |
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|iv. |................... |..........................................................................................................| |
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|v. |................... | | |
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|vi. |................... |.......... | |
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|vii. |................... |..........................................................................................................| |
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|viii. |................... | | |
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|ix. |................... |.......... | |
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|x. |................... |..........................................................................................................| |
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10. Results of Previous examination/s sat:
(To be completed by repeat / referred candidates)
Name of Examination:
First Attempt Second Attempt Third Attempt
Month / Year .............................. ............................ .............................
Index No .............................. ............................ .............................
Results .............................. ............................ .............................
(Fail, R3, R2 or R1)
11. Fees paid by repeat and referred candidates Rs. ............................................................................
(Please annex receipt form the Senior Assistant Bursar, ITUM in respect of the examination fee)
Date :................................ ...........................................
Signature of Candidate
12. I certify that the above student is eligible to apply for the NDT 1st/2nd Year Repeat Examination.
Date : ..................................... .......................................
Head of Division
13. Office Use :
Index No :
................
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