AL Application Form - 230711 - 073351

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G.C.E.

(A/L) Examination - 2023

1. Full name in English (According to the Birth Certificate)


…………………………………………………………………………………………………………………………………………………
2. NIC ………………………………………….
3. Gender ……………………………..
4. Date of Birth ……………………………….
5. Attempt number for this examination (1st or 2nd ) …………………………..
6. Date joined to the school (yyyy/mm/dd) : ………………………………….
7. Preferred Exam language medium (Sinhala or English or Tamil) ………………………………………
8. Subject 1 : ………………………………….. Medium : …………………………….
9. Subject2 : …………………………………… Medium : …………………………….
10. Subject 3 : …………………………………. Medium : ………………………………
11. Whether apply common General Test (yes or No) : ……………… Medium ………………………
12. Whether apply general English (yes or No) : …………………
13. Are you a student with special education needs? (yes or No) : …………………
14. Grade(13M1 or A1 or C1 etc) : …………………………
15. Tel No : ………………………………….

Above information are true and correct.

……………………………………… ………………………………………………
Signature of the Class Teacher Signature of the Applicant

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