^ld¾hd,hSh m%fhdackh i|yd&

…………………………………………………….………….. ;k;=r i|yd whÿï m;%h

1'0 fm!oa.,sl f;dr;=re :

1'1 uq,l=re w.g fhdod uq,l=re iu. ku ^bx.%Sis lemsg,a wl=frka& :- .........................................................
.........................................................................................................................................................................
^WodyrK' GUNAWARDHANA H.M.S.K.&
1'2 iïmQ¾K ku ^bx.%Sis lemsg,a wl=frka & :- ...............................................................................................
.........................................................................................................................................................................
^WodyrK' HERATH MUDIYANSELAGE SAMAN KUMARA GUNAWARDHANA&
1'3 iïmQ¾K ku ^isxyf,ka$fouf<ka& :- ......................................................................................................
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1'4 iaÓr ,smskh ^isxyf,ka$fouf<ka& :- .......................................................................................................
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1'5 iaÓr ,smskh ^bx.%Sis lemsg,a wl=frka& :- ..................................................................................................
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1'6 ia;%S$mqreI Ndjh :- ....................................................................................................................................
1'7 újdyl$wújdyl nj :- .............................................................................................................................
1'8 ck j¾.h :- ..............................................................................................................................................

1'9 cd;sl ye÷kqïm;a wxlh :-

1'10 Wmka Èkh :- j¾Ih udih Èkh

1'11 ÿrl:k wxlh :

1'12 Èia;%slalh :- .............................................................................................................................................

1'13 Pkao fldÜGdih :- ..................................................................................................................................
1'14 .%du ks,Odß fldÜGdih :- ......................................................................................................................
1'15 úoaHq;a ,smskh :- .......................................................................................................................................

2'0 wOHdmk iqÿiqlï :-

2'1 w'fmd'i' ^id' fm<& úNd.h : j¾Ih :- ……………………. úNd. wxlh :- ..........................................

úIhh idud¾:h úIhh idud¾:h

1' 6'
2' 7'
3' 8'
4' 9'
5' 10'

1
 2'2 w'fmd'i' ^W' fm<& úNd.h : j¾Ih :- ……………………. úNd. wxlh :- ...........................................

úIhh idud¾:h úIhh idud¾:h

1' 3'
2' 4'

3'0 jD;a;Sh iqÿiqlï :- ..........................................................................................................................................

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4'0 fjk;a iqÿiqlï :- ...........................................................................................................................................

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5'0 úuish yels {d;Ska fkdjk fofofkl= ms<sn| úia;r :

ku $ ÿrl:k wxlh moúh ,smskh
1'

2'

6'0 whÿïlref.a iy;slh :

^w& fuu b,a¨ï m;%fha ud úiska imhd we;s f;dr;=re ud okakd ;rñka i;H yd ksjerÈ nj f.!rjfhka
m%ldY lr isáñ' fuys hï fldgia iïmQ¾K fkdlsÍfuka iy$fyda jerÈ f,i iïmQ¾K lsÍfuka isÿúh
yels w,dNh ú| ord .ekSug tlÕ fjñ' ;j o fuys ish¨u fldgia ud okakd ;rñka ksjerÈj iïmQ¾K
lr we;s nj o m%ldY lrñ'
^wd& fuys i|yka lsisÿ f;dr;=rla miqj fjkia fkdlrñ'

…………………………………..
whÿïlref.a w;aik'
Èkh : ………………………..
2
7'0 w;aik iy;sl lsÍu :
fuu whÿïm; bÈßm;a lrkq ,nk …………………………...……………………………………………
……………………………………… uhd $ ñh $ fukúh ud fm!oa.,slj okakd y÷kk nj;a
…………………………… Èk ud bÈßfha§ Tyqf.a$wehf.a w;aik ;enQ nj;a iy;sl lrñ'

……………………………………………
w;aik iy;sl lrk ks,Odßhdf.a w;aik'
Èkh : ………………………..
iy;sl lrk ks,Odßhdf.a iïmQ¾K ku : ....................................................................................................
.........................................................................................................................................................................
;k;=r : ...........................................................................................................................................................
,smskh : ...........................................................................................................................................................
^ks, uqøfjka ikd: lrkak'&

8'0 whÿïlre uOHu rcfha fyda m<d;a rdcH fiajfha fiajlhl= kï fomd¾;fïka;= $ wud;HdxY
m%Odkshdf.a iy;slh :

fuu b,a¨ïlre jk ……………………………………………………………………………………….

uy;d $ uy;añh $ fukúh ±kg fuu wud;HdxYfha $ fomd¾;fïka;=fõ
……………………………………………… jYfhka iaÓr$;djld,sl$wkshï fiajlhl=$fiaúldjl
f,i fiajh lrk nj;a" Tyq$weh fuu ;k;=r i|yd f;dard.kq ,enqjfyd;a fiajfhka ksoyia l<
yels$fkdyels nj;a okajñ'
………………………….………………….
wdh;k m%Odkshdf.a w;aik' ^ks, uqødj&
ku : ................................................................................................................................................................
;k;=r : ...........................................................................................................................................................
,smskh : ...........................................................................................................................................................
Èkh : ..............................................................................................................................................................