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De Mazenod College,
Kandana, Sri Lanka Application Form for the Grade 12 – 2020/22
Closing Date: 15th May 2020
ONLY FOR DE MAZENOD COLLEGE STUDENTS
|01 |Name in Full : | |
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|02 |Date of Birth : | |
|03 |Address : | |
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|04 |Gender : | |NIC No : | |
|05 |Religion : | | |
|06 |Telephone : | |Mobile No : | |
|07 |Father’s Name : | |
|08 |Mother’s Name : | |
|09 |Present Class (Grade 11) : |Admission No : | |
|10 |Results obtained in G.C.E. (Ordinary Level) Examination |
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| |Index No : |
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| |Subject |
| |Results |
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| |Subject |
| |Results |
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| |1 |
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| |6 |
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| |2 |
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| |7 |
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| |3 |
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| |8 |
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| |4 |
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| |9 |
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| |5 |
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| |10 |
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|11 |Subject Stream you hope to follow (Please refer other side for details) |
| |1st Choice | |2nd Choice | |
| |Medium : | |
|12 |Details of the extracurricular activities you attend at present |
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| |For BIO SCIENCE |
| |(Chemistry / Physics / Biology ) |
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| |At least 5 A’s including Mathematics and Science and pass O/L Exam with six subjects. |
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| |For PHYSICAL SCIENCE |
| |(Chemistry / Physics /Combined Maths / ICT) |
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| |At least 5 A’s including Mathematics, ICT and Science and pass O/L Exam with |
| |six subjects. |
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| |For COMMERCE (Sinhala & English Medium) |
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| |COMMERCE I |
| |(Business Statistics/Accounts/Economics ) |
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| |At least 3 A’s with A or B for Mathematics and at least C for Business Studies and pass O/L Exam with six subjects |
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| |COMMERCE II |
| |(Business Studies/Accounts/Economics or ICT) |
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| |At least 3 A’s, C for Business Studies & ICT is compulsory, one ‘C’ for Mathematics and pass O/L Exam with six subjects. |
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| |For ARTS |
| |Pass O/L Exam in six subjects with Maths and 3 C’s |
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| |Select one subject each from following subject combinations |
| |Political Science/Mass Media/Economics/French/Japanese |
| |Sinhala Language/Logic/ English Literature/ Geography / ICT |
| |History / Christianity / Dancing / Eastern Music/Western Music/Art/Drama |
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| |N.B For. English. Literature - ''A'' pass in English. Literature in the O/L |
| |For French - “A” pass for English Language in the O/L |
| |For IT - “B” pass in the O/L |
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| |I CERTIFY THAT THE PARTICULARS FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. |
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| |……………………………… ……………………. …………………………………. |
| |Signature of the student Date Signature of Parent/Guardian |
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| |PLEASE NOTE : SIGNATURES ARE NOT REQUIRED TO SUBMIT THE APPLICATION |
| |VIA E-MAIL |
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