Faculty of Medicine, University of Kelaniya

APPLICATION FOR POST OF PRE-INTERN TEMPORARY

DEMONSTRATOR

1.
2.
3.
4.

A. Personal information
Name of applicant: MADUSHA PRASHAN SAMARASINGHE
Postal address590, NINDAHENA, GOTHATUWA.
E-mail address: madushasamarasinghe1234@gmail.com
Telephone number (preferably mobile): 0755886335

B. Academic record
1. University: SRI JAYAWARDANEPURA
..
2. Final MBBS examination results (if available):
Passed on: PENDING. (mm/yyyy)
Degree classification: First class / Second upper / Second lower /
Pass
(underline whichever is applicable)
Distinctions or Gold medals: ..
3. 3rd MBBS examination or equivalent:
Passed on: 2013. (mm/yyyy)
Degree classification: First class / Second upper / Second lower /
Pass
(underline whichever is applicable)
Distinctions or Gold medals: NO..
4. 2nd MBBS examination or equivalent:
Passed on..2011. (mm/yyyy)
Degree classification: First class / Second upper / Second lower /
Pass
(underline whichever is applicable)
Distinctions or Gold medals: ..
5. Any other information relevant to academic abilities
RESEARCH ON FACTORS ASSOCIATED WITH UNPLANNED
PREGANANCIES ..
C.
D.
Deans Office 8 January 2015

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Faculty of Medicine, University of Kelaniya

E.
F.
G.
H. Preferences for appointment
(please indicate preferred appointments in order of priority)
Administrative entity
1. Dept of Anatomy
2. Dept of Biochemistry & Clinical
Chemistry
3. Dept of Disability Studies
4. Dept of Family Medicine
5. Dept of Forensic Medicine
6. Dept of Medical Microbiology
7. Dept of Medicine
8. Dept of Obstetrics & Gynaecology
9. Dept of Paediatrics
10. Dept of Pathology
11. Dept of Parasitology
12. Dept of Pharmacology
13. Dept of Physiology
14. Dept of Psychiatry
15. Dept of Public Health
16. Dept of Surgery
17. Medical Education Centre
18. Colombo North Transplantation
Services

Preference
1
2
3
5
15
16
14
13
12
11
10
9
8
17
7
6

I declare that the information provided above is true. If offered an

appointment, I will provide an official transcript of my academic record.
23
/01/2015

.
Signature

Date

Closing date for submission of applications: 20 January 2015

Completed applications and biodata should be emailed to
or sent by post to the The Dean, Faculty of Medicine, University
of Kelaniya, P. O. Box 6, Talagolla Road, Ragama.

Deans Office 8 January 2015

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