Application

ETMA Application Form

ACCOUNT NAME: ENGINEERING TECHNOLOGY – MASTER IN AUTOMATION CAMPUS (PVT) LTD
BANK NAME: COMMERCIAL BANK,
ACCOUNT NO: 1000449974,
BIC: CCEYLKLX,
BANK ADDRESS: COMMERCIAL BANK, MILAGIRIYA BRANCH, BAMBALAPITIYA, COLOMBO-04, SRI LANKA.

Title:

First Name:

Last Name:

Nationality:

IF Sri Lankan ( NIC No / Passport No):

If Overseas Student ( Passport No):

Date of Birth:

Email:

Phone No:

Alternate Phone No:

Postal Address:

Please Select your Course:

Please Enter Any Educational Qualifications:

Please Mention Past Experiences:

Recommended By:

Message / Comment: