G.C.E. (A/L). I certify that the information given above is true and correct. I further state that the receipts for the
National Institute of Education Application for Diploma in Additional Language Improvement 2018 01. District
02. Course
Sinhala
Tamil
English
(Tick the relevant box)
03. Name with Initials 04. Names Denoted by Initials 05. Date of Birth NIC Number
D
D
M
M
Y
E
A
R
Age
06. Private Address (Permanent)
Telephone No 07. Official Address
Telephone No 08. Designation 09. Educational Qualifications G.C.E. (A/L)
Year
Index No
Subject
Grade
I certify that the information given above is true and correct. I further state that the receipts for the fees for the application processing and admission test are attached. Date: …………………………..
………………………………... Signature of the candidate ----------------------------------------------------------------------------------------------------------------------------- ---------------------Recommendation of the Department Head I recommend and forward the application of Rev/Mr/Ms ……………………………………………………………………. Date: …………………………..