For Office Use Only

DEPARTMENT OF CIVIL ENGINEERING

FACULTY OF ENGINEERING
UNIVERSITY OF PERADENIYA

POSTGRADUATE PROGRAMME IN CIVIL ENGINEERING

APPLICATION FOR ADMISSIONS – 201_

1. NATIONAL ID / PASSPORT NO:

Mr./ Ms/ Dr. (Delete whichever is in applicable)

NAME WITH INITIALS:

NAMES DENOTED BY INITIALS:

EMAIL :

2. HOME ADDRESS:

Telephone: Mobile No:

OFFICIAL ADDRESS:

Telephone: Email:

ADDRESS FOR CORRESPONDED (Home/Official)

(Delete whichever is an applicable)

Senior Assistant Registrar should be informed immediately of any changes in either address

3. DATE OF BIRTH: D D M M Y Y Y Y

4. NATIONALITY:

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 5. PRESENT EMPLOYMENT ( Designation):

6. NAME AND ADDRESS OF EMPLOYER:

7. EMPLOYMENT RECORD (List your most recent position first):

Name and Address of Period

Position/Rank Nature of Duty
Employer From To

8. EDUCATIONAL\PROFESSIONAL QUALIFICATIONS (Copies of certificate/s to be attached):

University or Institute From To Degree Field Class/Pass

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 9. LIST OF PUBLICATIONS (use separate sheet if space is not adequate) :

10. PROGRAMME OF STUDY: (tick as appropriate)

10.1 Degree applied for

PGDip M.Sc. M.Sc.Eng.

10.2 Preference for postgraduate programme (most preferred-rate 1, least preferred-rate5)

Geotechnical Engineering

Highway and Traffic Engineering

Structural Engineering

Sustainable built Environment

Water and Environment Engineering

11. DOCUMENTS TO BE SENT:

a. Two letters of recommendation (at least one should be from the applicant’s teacher
at university)
b. Degree/Diploma certificate/s (Photostat copy/ copies)*
c. Birth certificate (Photostat copy)*
d. 2 self-addressed envelopes (22X10 cm)
e. *Originals have to be produced on request/at the time of interview

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 12. REFERENCES: (Give names and addresses of two referees, at least one of whom should have been
your teacher at the University)

Name : ……………………………….. Name : ………………………………..

………………………………………… …………………………………………

Address : ……………………………… Address : ………………………………

…………………………………………. ………………………………………….
…………………………………………. ………………………………………….
………………………………………….. …………………………………………..

Note: Forms for Referees Report annexed hereto should be handed over to the referees indicated above.
They should be requested to send their reports duly perfected, directly to the Coordinator,
Postgraduate p r o g r a m of Civil Engineering under confidential cover. However, if the sealed
envelopes are given to you personally, such reports should be attached to this application.

13. DECLARATION OF THE APPLICANT

I do hereby declare that particulars provided by me in this application are true and accurate to the best
of my knowledge, and that i am not registered for any degree program in any University in Sri Lanka
at the time of this application. In the event of me being selected for the program of study I have
applied for, I hereby agree to abide by such Regulation of the Institute as are applicable to me.

Date: ............................................. ............................................................

Signature of Applicant

Perfected application in duplicate with the supporting documents to be sent under registered post to
st
Senior Assistant Registrar, Faculty of Engineering, University of Peradeniya, before 31 July 2017
Please indicate “PG/Civil Engineering” on the top left hand corner of the envelop.

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Date:

TO ALL STUDENTS OF THE POSTGRADUATE PROGRAAME IN CIVIL ENGINEERING

CONFIRMATION OF NAME TO BE APPEARED IN THE DEGREE CERTIFICATE

Please note that you are required to indicate in the following cage the manner in which your name should
be spelt out in the degree certificate to be awarded to you at the convocation.

Name of the student:…………………………… Signature of student:………………………….

Please indicate your full name in BLOCK LETTERS as appeared either in your first degree certificate
that has been awarded to you at the convocation or a detailed certificate which has been forwarded to the
Postgraduate program of department of Civil Engineering at the time of your first registration, a copy of
which (transcript or a degree certificate) should also be attached for our reference when you apply for the
final examination.

Please note that your name will be indicated in the degree certificate as appearing above and that no
changes will be made to it once you have given this form to the Postgraduate program of department of
Civil Engineering , except in case where of a female student who could make a request to change their
name after the marriage. In such a case, those students are required to submit a certified copy of the
marriage certificate for our reference.

Assistant Registrar/ Faculty of Engineering

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