UNIVERSITY OF COLOMBO, SRI LANKA
UNIVERSITY OF COLOMBO, SRI LANKA
FACULTY OF GRADUATE STUDIES
APPLICATION FOR ADMISSION
PERSONAL DATA
NAME IN FULL :………………………………...………………………………………………………………………… …………………………………………………………………………………………………………... ……………………………………………………………………………………………………………
NAME WITH INITIALS :………………………………………………………………………..................................................
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CONTACT ADDRESS :……………………………………………………………………….................................................
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HOME ADDRESS :………………………………………………………………………..................................................
(If home address defers from contact address) …………………………………………………………………………………………...
TELEPHONE :HOME :………….……….…OFFICE:…….…….….…………..MOBILE:…….…...………………….
E-MAIL :………………………………………………………………………....................................
DATE OF BIRTH :………./….……./19….…. NIC NO:……………….………………….
DATE / MONTH / YEAR
NATIONALITY :……………………….….. CIVIL STATUS:….…………................
SEX : MALE / FEMALE
EDUCATIOANL QUALIFICATIONS:
University Education (Submit Certify Copies):
|Degree |Class |University(If applicable) |Date of Degree |
| | | | |
| | | | |
| | | | |
Professional Qualifications with full details: *
|Course |Duration | |Date of Award |
| | |University/Institute | |
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| | | | |
| | | | |
*Submit certified copies if the applicant is not a graduate
Any other Qualifications:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
WORK EXPERIENCE
Please list the employment background, beginning with your most recent position.
| Date |Name & Address of Employer |Position |
|From |To | | |
|D/M/Y |D/M/Y | | |
| | | | |
| | | | |
| | | | |
| | | | |
Are you currently registered student of any degree programme in Colombo University or any other Higher Educational Institute? Explain:
……………………………………………………………………………………………………………………………………………………………………………………………………………………
A brief description of current responsibilities:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
I certify that the above particulars given by me are true and accurate to the best of my knowledge and I am prepared to abide by the rules and regulations of the University of Colombo, Sri Lanka.
Date: …………………….. …………………………………………….
Signature of Applicant
FOR OFFICE USE ONLY
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Application No:.................
Reg. No: 2021/PgDCP/…..
POSTGRADUATE DIPLOMA IN COUNSELLING & PSYCHOSOCIAL SUPPORT
2021/2022
(Underline the Last Name)
Academic Qualifications
Professional Qualifications
Other experience
Qualified for the Programme
Recommendation of the selection Committee
Photograph Here
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