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Application form for Hostels
Academic Year - 2021/2022 ( Only for first year students of Faculty of Allied health Science )
( Fill in English language )
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* Indicates required question
01.) Name with Initials ( Example - M.N.P. Jayasooriya )
*
Your answer
02.) Permanent Address
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Your answer
03.) Gender
*
Rev
Male
Female
04.) NIC Number
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Your answer
05.) Contact Number
*
Your answer
06.) Faculty
*
Faculty of Management studies and commerce
Faculty of Humanities and social sciences
Faculty of Applied sciences
Faculty of Allied health sciences
Faculty of Engineering
Faculty of Urban and aquatic bio resources
Faculty of Dental sciences
Faculty of Technology
Faculty of Computing
Faculty of Medical sciences
07.) Distance between the permanent address and the Faculty without km ( Example - 120 )
*
Your answer
08.) Total Monthly Income in all the sources ( only the amount without Rs. ) Example - 66000.00
*
Your answer
09.) Do your family receives samurdhi
?
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Yes
No
10.) Number of brothers/sisters in your family ( Age under 06 years) ?
*
Choose
1
2
3
4
5
None
11.) Number of brothers/sisters in your family ( Age between 06 - 20 years) ?
*
Choose
1
2
3
4
5
None
12.) Number of University undergraduates in your family ?
*
Choose
1
2
3
4
5
None
13.) Is your father alive ?
*
Yes
No
14.) Is your mother alive ?
Yes
No
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