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Course Application/Participant Bio-Data
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* denoted are required fields

 

1)  Title of Course :  *

2)  Name in Full: 

3)  Name with Initials:*  Title : *

4) Nationality:      
      

Age:

5)  National Identity Card No./Passport No: 

6) Select Country :

7)  Present Post: 

8)  Office Address:

 

Tel:      

Fax:   

E-mail:* 

9)  Home Address: *

 

Tel:        

10)  Educational Qualifications: (start with the last Institution attended)

  Institution                     Years attended   Field of Study      Degree/Diploma  

11)  Employment: (start with the present employment)

Title/Position                    Organization                 Period              Duties  

12)  Other Experience:  

13)  Reasons for deciding to follow this course:  

 

      

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Information: chpb@sltnet.lk