Application - Academic

THE OPEN UNIVERSITY OF SRI LANKA
FORM OF APPLICATION
POST: DIVISION: CENTRE :

(Indicate the name of the post as given in the advertisement)
01. (a) Name with initials :
(b) Names denoted by :

initials
02. Whether Rev/Mr/Mrs/Miss :
03. (a) Postal Address :
(Any change should be

communicated immediately)
(b) Tel. No : Res. Off.

Fax No :
E-mail :
04. (a) Date of Birth :
(b) Age as at the closing :
date of applications
05. Civil Status :
06. Whether Citizen of Sri Lanka :
(State whether by descent or by
registration) if by
registration give reference
number & date of certificate of
citizenship
07. Education School Attended : From To
(1)
(2)
(3)
(4)
(5)
Contd.../2
08. University Education: Copies should be attached

Degrees/Diploma Class University Effective Duration
Date
1.
2.
3.
1
4.
5.
09. Professional Qualifications:

Institution Qualifications Effective Duration
obtained Date
1.
2.
3.
4.
5.
10. Postgraduate Qualifications:

Postgraduate University By Course Effective Duration
Degree/ Diploma or Date
(Prescribed
By Research period of
Registration)
1.
2.
3.
4.
5.
Contd... /3
11. Any other academic :
distinctions, scholarships,
medals, prizes etc.
(Indicate the Institution
from which such awards have
been obtained)
12. Research & Publications if :

any (If space is
insufficient, please use
separate sheet of same size)
2
13. State under which category :
you are eligible to apply
14. Highest examination passed

in Sinhala/Tamil
15. (a) Present occupation :
(b) Date of Appointment :

(c) Salary drawn :
(State whether basic or
consolidated)
(d) Name of Employer/ :
Institution & Address
(e) Previous appointments :

if any with dates
16. Extra Curricular activities :
Contd .../4
17. Any further relevant :

particulars
(Not included above)

18. Name of two persons (with addresses to who reference can be made)
Name Address
1. ......................... .......................................
.......................................
.......................................
.......................................
2. ......................... .......................................
.......................................
.......................................
.......................................
I do hereby certify that particulars submitted by me in this application are

true and accurate. I am aware that if any of these particulars are found to be
false or inaccurate, I am liable to be disqualified before selection and to be
3
dismissed without any compensation if the inaccuracy is detected after
appointment.
Date : ........................ .........................

Signature of Applicant
Recommendation by the Head of the institution:

I recommended the above application and agree to release the applicant
in case he is selected for the post applied for
.........................
Signature of the Head of Institution
D E C L A R A T I O N F O R M
Every applicant should fill this form
1. Post applied for :

at the Open
University
2. Full Name :
3. Address :
4. Designation :
5. Name of Employer :
6. Address :
7. Reasons for :
leaving previous
service
4
Name of Designation Duration Reasons for leaving
Employer whether terminated/
dismissed/ vacated/
retired/ resigned/
released on secondment
1.
2.
3.
4.
5.
8. Have you entered in to a Bond/ Agreement with any of your

previous employer/s for Training/Study Programme:
i Nature of :
Training/ Study
programme
ii. Obligatory :
Period

iii. Date of :
Commencement of
obligatory
period
iv. Date of expiry :
of obligatory
period
v. Monetary value :
of the Bond

I declare that the above information is true to the best of my

knowledge.
Date :
Signature of Applicant
5
Observations of the Head of the Institution.
N.B. 1. Written answers should be provided in each section. Leave
no section unanswered. If any section is not applicable
please write word inapplicable.
2. If the space provided under each section is inadequate,

you are free to use additional paper and place your
signature and date on each such additional paper.
3. Copies of Educational Certificates/ Training Programs/

Experience should be annexed with the application.

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THE OPEN UNIVERSITY OF SRI LANKA

POST: DIVISION: CENTRE :

(b) Names denoted by :

(Any change should be

(b) Tel. No : Res. Off.

08. University Education: Copies should be attached

09. Professional Qualifications:

10. Postgraduate Qualifications:

12. Research & Publications if :

14. Highest examination passed

15. (a) Present occupation :

(b) Date of Appointment :

(e) Previous appointments :

17. Any further relevant :

(Not included above)

I do hereby certify that particulars submitted by me in this application are

Date : ........................ .........................

Recommendation by the Head of the institution:

Every applicant should fill this form

1. Post applied for :

8. Have you entered in to a Bond/ Agreement with any of your

I declare that the above information is true to the best of my

2. If the space provided under each section is inadequate,

3. Copies of Educational Certificates/ Training Programs/

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