Application Number -
Declaration form for [Link]. Management (Public) General (External) Degree
(2021)
Name in Full :…………………………………………………………………………
Name with Initials :…………………………………………………………………………
Permanent Address :…………………………………………………………………………
Residence Telephone :……………………………………..
National Identity Card No :……………………………………..
Mobile Telephone :………………………………….....
Email :…………………………………….
Medium :………………………
Please paste your photograph here.
Colour Photograph should be 3.5 º 4.5 cm size with white
background.
Photograph should be attested by signing on the photograph 3.5 º 4.5
By authorized person.
I certify that I have read and understood the rules and regulation pertaining to registration procedures of
the University.
…………………….. ……………………….
Signature of Application Date
*Attestation
I certify that the above named candidate who is known to me and certify attached photograph owned to
his/her.
Name :
Designation :
Signature :
Date : ………………………..
Official Seal
*Signature & Photograph should be attested by Grama Niladhari of the Division/Head of a
Government or Approved School/ a teacher or an Executive Officer of a University, or a Justice
of the peace or a Staff Officer /Government Department or a person of similar status.
Checked By : ………………….