National Institute of Education Application for Diploma in ... - Nie

G.C.E. (A/L). 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 ...
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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: …………………………..

…………………………...... Signature (Official stamp)