UNIVERSITY OF MORATUWA, SRI LANKA Application for Admission to the MSc / PG Diploma Course in Electrical Engineering Mr/ Ms/Other (specify) Name with Initials 1 Last Name Sex : Male/ Female Other names Residential Address Telephone No: Fax : Office Address 2 Telephone No: Address for Correspondence Fax : Residential / Office/Other (specify) Telephone No: email : Age on 01-10-06 3 Date of Birth 4 Nationality: Sri Lankan / Other (specify) 5 Civil Status: Married / Single / Other (specify) 6 N.I.C. No. Academic Qualifications: Dates University / Institute From 7 To Qualification & Class (if any) Field of Specialisation Professional Qualifications Professional Institute 8 Years Membership Grade Date of Election Relevant Experience Dates Post Held / Designation Name and Address of Organisation From To 1 9 Awards, Scholarships, Fellowships (Details including dates) 10 Publications & Presentations (Details including dates) 11 Referees (Name, Designation, Address & Telephone No.) (1) (2) I Certify that the particulars furnished above are true to the best of my knowledge. Date Signature Notes to applicants 1. 2. 3. 4. 5. 6. 7. Please type or write in block letters. Please delete any inapplicable words. Only photo-copies of academic and other qualifications should be sent with the application. Only short listed applicants will be called for an interview. At the interview applicants should produce the originals or certified copies of the requisite certificates at the interview. Around 25 candidates will be selected to follow the course. The course would normally be conducted on weekends. Those selected for the course will need to obtain a release from the employer to follow the course. The course is expected to commence around the end of October 2006. Please note that only a selected set will be permitted to proceed to the MSc based on the performance at the postgraduate examinations during the first year. Completed application forms should be sent to the following address with MSc/PGDiploma in Electrical Engineering written on the top left hand corner of the envelope. Head/Department of Electrical Engineering University of Moratuwa, Sri Lanka Moratuwa Sri Lanka. Closing date of Applications: 11 July 2006. Information Dr. Lanka Udawatta - Department of Electrical Engineering Email: lanka@elect.mrt.ac.lk Prof. H. Y. Ranjit Perera - Head of Department of Electrical Engineering Email: headee@elect.mrt.ac.lk 30 May 2006 2