PRACTICAL EXAMINATIONS IN WESTERN MUSIC 20…….. ENTRY FORM This form must be completed legibly and accurately and forwarded to the Commissioner General of Examinations, Organization & Foreign Examinations Branch, Department of Examinations, Pelawatte, Battaramulla by Registered post. The name of the Examination should be written on the top left hand corner of the envelope. These Examinations will be held in Colombo, Galle, Kandy, Badulla and Kurunegala.
Any centre which does not have a sufficient number of candidates will be cancelled and the respective candidates will be directed either to the centre of their Second Choice or to a suitable Centre.
Mr./Miss/Mrs. ………………………………………………………………………………………………………. (In block Capitals: This name must be used at all stages of the examination), (Ex: PERERA, C.N.A.)
(ii) Names denoted by Initials: ............…………………………………………………………………………………
...................................................................................................................................................... (for dispatch of Admission Card) Tele. No.
3. Date of Birth: Day Month Year 4. Sex Male / Female
5. (i) Grade/Diploma applied to be examined :
(ii) Aspect to be examined: (Piano, Violin, Cello)
6. To be perfected only by Candidates Applying for Grade VI – VIII Practical Examination. *
(a) Year of passing G.C.E. (O/L) Western Music: ................. Grade obtained: .................. Index No.: ......................
(b) Year of passing G.C.E. (A/L) Western Music: ................. Grade obtained: .................. Index No.: ......................
(c) Year of passing Grade V Theory or higher Examination in Western Music of the Department of Examinations:
Grade obtained: .................. Index No.: ......................
7. To be perfected only by Candidates Applying for National Diploma in Western Music. *
(a) Year of passing Grade VIII Theory: …………………… Grade obtained: …………… Index No.: ……………
(b) Year of passing Diploma General Paper: ....…………… Grade obtained: …………… Index No.: ……………
*Please attach the photocopies of the relevant certificates having certified them as the true copies by the attestor (P.T.O.) 8. Fees paid Rs.
CAGE FOR RECEIPT
GRADE I - Rs. 600/- Grade IV – Rs. 600/- Grade VII - Rs. 800/- GRADE II - Rs. 600/- Grade V – Rs. 800/- Grade VIII - Rs. 800/- GRADE III - Rs. 600/- Grade VI – Rs. 800/- DIPLOMA TEACHERS - Rs. 2000/- DIPLOMA PERFORMERS - Rs. 2000/-
Candidates should affix the receipt for examination fee paid at a post office. They are advised to keep a photocopy of the receipt with them.
9. I certify that the information given in this form is correct. I do hereby agree to be bound by the Regulations of this Examination, and the Rules for Candidates issued by the Commissioner General of Examinations.
10. Attestation of Identity.
I certify that the above named candidate who is personally known to me placed his / her signature in my presence today.
………………………………………. ……………………………………. Signature of Candidate Signature of Attestor
Date ………………………….
Name of Attestor ………………………………………………………………….
Designation / Status ………………………………………………………………
Address ……………………………………………………………………………
…………………………………………………………………………….
…………………………………………………………………………….
The Attestation required on this form should be made by a Justice of the Peace, Commissioner of Oaths, Attorney at Law or Notary Public, or a permanent Government officer in receipt of an annual consolidated salary of Rs. 240 360/- or over, Head of a Government / Director Managed / approved School or the incumbent of a place of worship or a religious dignitary of standing or the Grama Niladhari of the Division, or a Principal of the private Music school presenting candidates for this examination.
