Ocean University of Sri Lanka Application - 2017

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OCEAN UNIVERSITY OF SRI LANKA For office use only

APPLICATION FOR DEGREE PROGRAMMES


NIC No.

Select only one course of preference for course of study from the following table.
01 B.Sc. in Marine Engineering (Shore based)
02 B.Sc. in Marine Engineering (Merchant Navy Sea Farer Career)
03 B.Sc. in Fisheries and Marine Science
04 B.Sc. in Maritime Transportation Management & Logistics
05 B.Sc. in Coastal and Marine Resources Management
01. Name (In block letters)
(a). Full name:

(b). Name with initial: Mr. /Miss:

(a). Permanent address:


02.

(b). Res. Tel No: Mobile No:


(c). E-mail:

Date Month Year Date Month Year


03. Date of birth 04. Age as at 07/03/2017
Single Married Male Female
05. Civil status 06. Sex:
07. Sri Lanka Citizenship: By Decent By Registration

08. Educational Qualifications:

(a) GCE (O/L) Examination: (b) GCE (A/L) Examination: (2016) results
Name of the School Name of the School
.................................................... ...................................................................
.................................................... ...................................................................
Index No:..................................... Index No:....................................................
Year: ........................................... Stream..

Subject Grade 1st attempt 2nd attempt 3rd attempt

1. English . Subject Sub_No Grade


2. Maths . 1) ..
3. Science . 2) ..
4. .. . 3) ..
5. .. . 4) English
6. .. . Common General Test Marks
7. .. .
8. .. . Whether you have been qualified for University
9. .. .
Admission Yes No

Z-score
Maximum Grade obtained for English Language at the G.C.E (O/L) Examination
Index No: Year:

Maximum Grade obtained for Mathematics at the G.C.E (O/L) Examination


Index No: Year:

09. Any other relevant facts:


........................................................................................................................................................................
........................................................................................................................................................................
........................................................................................................................................................................
........................................................................................................................................................................
(Please attached a separate sheet if necessary)

10. Details of Father/Mother/Guardian)

I. Father
(a) Name:

(b) Address:

(c) Res. Tel No: Mobile No:


(d) Present Employment:
...........................................................................................................................................................

(e) If retired, Previous Employment :.


...........................................................................................................................................................

II. Mother
(c) Name:

(d) Address:

(c) Res. Tel No: Mobile No:


(d) Present Employment:
...........................................................................................................................................................

(e) If retired, Previous Employment :.


...........................................................................................................................................................

III. Guardian (if applicable)


(a) Name:

(b) Relationship:

(c) Res. Tel No: Mobile No:

11. Credit LKR 500/-(Rupees five hundred) per Degree Progaramme to any branch of Peoples Bank
in favour of Vice-Chancellor, Ocean University of Sri Lanka bearing Current Account No
214100163629909.
Please paste the original Bank Slip here

Please submit following details with respect to the payment

i. Date of payment: .
ii. Branch of the bank where the pay payment is made: .

15. I declare in honour that the information given above are true and accurate to the best of my
knowledge. I am aware that if any information given in the application are found to be incorrect, prior to
my selection I am liable to be disqualified, and if it is found after the selection I am liable to be dismissed
without any compensation.

Applicants should also enclose envelop with a stamp for the value of LKR 40/- (Rupees Forty) along with
the application.

(I) Please tick off the following table to ensure the documents/certificates attached.

Attachments
Certified copy of G.C.E (O/L) certificate
Certified copy of G.C.E. (A/L) certificate with Z
Score and Common General Test
Certified copy of Birth certificate
Original payment slip
Envelop with rupees 40.00 stamp

.
Date Applicant Signature

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