APPLICATION FORM SRI LANKAN ASTRONOMY AND ASTROPHYSICS OLYMPIAD COMPETITION 2009

(This application form is also available at www.ip-sl.org website. Photocopies of this application form too are accepted.)

1. Name in full: . 2. Name with initials: 3. Date of Birth : Day Month Year Months ; 4. Gender : Male/Female Years

5. Age as at 1st January, 2009* : Days

6. Name of the school:... 7. Address of the school: 8. Contact address: 9. Contact Tel. number: 10. E mail address (if available):.. 11. Preferred medium of instruction: Sinhala 12. Preferred Examination Center/University Colombo Batticaloa Peradeniya Jaffna I state that the above particulars are true and correct. . Signature of the applicant Students those who have sat for the A/L examination and left the school too can apply provided their age is less than 19 years to the 1st January 2009. (The examination will be held at the above centers on 18.07.2009 at 11.00 a.m. just after the finishing of the Physics Olympiad). ------------------------------------------------------------------------------------------------------------------------ Payment (Rs. 400/=) should be deposited into Physics Olympiad Fund - Bank of Ceylon Bambalapitiya branch (Branch code 037 Acc. No: 0781494) Please remember to enclose the deposit slip for the correct amount with the application form. Please do not send cheques or money orders. We will not accept them. Mail your application form or hand deliver it with two self addressed stamped envelopes to Dr. K P S Chandana Jayaratne Coordinator of the Astronomy Olympiad Competition The deadline to send the Institute of Physics, Sri Lanka payment and application form is C/O Department of Physics 30th June 2009 University of Colombo, Colombo 03. (Tel: 0714 800800) Kelaniya Matara English Tamil