Surname
*
Ex: M T Perera
Other Names
*
Ex: Manjula Theekshana Perera
Address
*
Ex: 1234 Main St Colombo
E-mail
*
Ex: manjula@sample.com
Phone 1
*
Ex: 0712345678
Phone 2
NIC Number
*
Ex: 199312345678
Dat of Birth
*
Ex: 2005-01-01
Admission Year
*
2000
Admission Class
*
Ex: 1-Nelum or 8-C
Admission Number
*
12345
Leaving Year
*
2013
Leaving Class
*
Ex: 13-Bio or 8-C
Type of Employment
*
Government
Corporation
Private Sector
Own Business
Professional
Other
Designation
*
Ex: Government Officer
Office Address
Ex: 1234 Main St Colombo
Office Phone 1
Ex: 0712345678
Office Phone 2
Leaving Certificate
Upload Your Leaving Certificate
Transaction Slip
Select 5000/= transaction slip
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