Applicaton Form

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Application Form

Required *

Union Member's Name: Mr/Mrs

Applicant Student's Name

Union Name :

UPTONPTWUSLPTSU

Date of Birth

Relationship to the Member

Members Office Address

Members Private Address

Contact Details :

a) Office Tel No

b) Private Tel No

c) Mobile No

d) Email

Family Details :

Spouse's Name :

Is he/she Working :

YesNo

If Yes State the instiution & Designation?

Details of Family Members :

01)

Name:

Age

School / Other

Monthly Income

02)

Name

Age

School / Other

Monthly Income

03)

Name

Age

School / Other

Monthly Income

Results of G.C.E O/L 2023-2024 First Attempt (Category A Only)

Results of G.C.E O/L 2023-2024 First Attempt (Category A Only)

Year of Examiniation :

Index No:

01) Religion

11) Extra Subject (if any)

12) Extra Subject (if any)

*Please submit the following documents along with the application.
(Every attachment should be below 1MB Capacity)

01) Category A. Scan copy of the original result sheet first attempt certified by the principal to be enclosed here…

03) Category B if the applicant already in the University a letter from Registrar certifying the course of study and the duration of the course.

04) Students who are already selected for University education a letter from the University Grant Commission

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