Viyathmaga Membership Application Form
එන්න අප හා එක්වන්න! දක්ෂ නායකයෙක් යටතේ වැඩ කරමු! අපි එකතු වී අපේ රට සංවර්ධනය කරමු!
* Required
PERSONAL DETAILS
Title:
*
Choose
Mr
Ms
Dr (PhD)
Dr (Medical)
Professor
Full Name:
*
Your answer
Gender:
*
Choose
Male
Female
Age:
*
Choose
18-24 years old
25-34 years old
35-44 years old
45-54 years old
55-64 years old
65-74 years old
75 years or older
LinkedIn Profile (URL)
Your answer
Facebook Profile (URL)
Your answer
CONTACT DETAILS
Postal Address:
*
Your answer
Mobile Number:
*
Your answer
Mobile Number:
Your answer
Email:
*
Your answer
District:
*
Choose
Ampara
Anuradhapura
Badulla
Batticaloa
Colombo
Galle
Gampaha
Hambantota
Jaffna
Kalutara
Kandy
Kegalle
Kilinochchi
Kurunegala
Mannar
Matale
Matara
Monaragala
Mullaitivu
Nuwara Eliya
Polonnaruwa
Puttalam
Ratnapura
Trincomalee
Vavuniya
Divisional Secretariat:
*
Your answer
Country (If you are living outside Sri Lanka)
Your answer
PROFESSION
Classification:
*
Professional
Businessman
Entrepreneur
Other:
Required
Current Employer
*
Your answer
Current Job Position
*
Your answer
Education Qualification
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Choose
PhD
Masters
Degree
Chartered Accountant
Chartered Engineer
Chartered Marketer
Other Charted Qualification
Attorney
Advanced Diploma
Diploma
Under Graduate
Other (Specify below)
Education Qualification (Specify)
*
Your answer
Profession:
*
Choose
Accountant
Administrator
Advertising Specialist
Agriculturalist
Architect
Artist
Astrological Specialist
Attorney at Law
Auditor
Ayurvedic Doctor
Banker
Businessman
Chemist
Communication Specialist
Corporate Head
Director
Economist
Educationalist
Engineer
Entrepreneur
Environmentalist
Ex Serviceman
Executive
Female Activist
Foreign Service Specialist
Geologist
Government Officer
Graduate Trainee
Hotelier
IT Specialist
Judge
Landed Proprietor
Lecturer
Manager
Media Activist
Medical Doctor
Nationalist Activist
Pharmacist
PhD Holder (Dr)
Photographer
Planter
Professor
Proprietor
R&D Specialist
Researcher
Reverend Priest
Scientist
Statistician
Writer
REFEREE'S DETAILS
The name & the contact number of the person you introduced to Viyathmaga.
Name:
*
Your answer
Contact Number:
*
Your answer
CONSENT
Active Participation:
*
Your active participation in organizing meetings, policy planning, membership drive & communication.
Choose
Yes
No
How would you like to contribute to Viyathmaga :
*
Your answer
*
I hereby confirm that above information are true and accurate.
Required
*
I hereby give consent to Viyathmaga to send me relevant updates via post, email and mobile messaging
Required
We assure that your data will not be shared with anyone without your consent.
Viyathmaga Secretariat
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