SRI LANKA INTERNATIONAL BUDDHIST ACADEMY (SIBA)
Sri Lanka International Buddhist Academy, Pallekele, Kundasale 20168 (Kandy District)
Tel: 94-(0) 81-2421693
Fax: 94-(0)81-2421692
Email: /
www.siba.lk
Application Form
(Please fill in this form completely using capital letters)
Programme Applied For(Please type “X” in appropriate box) / PhD in Buddhist Studies / PHOTOGRAPH
MA in Buddhist Studies
BA in Buddhist Leadership
Diploma in
Certificate in
Other
PERSONAL PARTICULARS
Name (As in Passport for International Student / As in NIC for Sri Lankan Student)
Intake
Month / Year
Date of Birth
Day / Month / Year / Age
Gender Male / Female Marital Status: Married / Single
Place / Country of Birth Nationality
Religion
NIC No. or Passport No
Correspondence Address
Postal Code Country
Telephone No. Fax No.
Mobile-phone No. E-mail
If you are an ordained person, please fill in the particulars below:
Name of Preceptor:
Date of Ordination:
Name of Temple:
Name of the Denomination:
ACADEMIC ACHIEVEMENT (attach certified copies of Certificates)
Name of Examination: Month / Year Completed:
Name of Institution: Location:
Name of Examination: Month / Year Completed:
Name of Institution: Location:
Documents to be attached:
· Certified copy of degree/s or diploma/s or certificate/s
· Certified examination results transcripts
· Other relevant supporting document (testimonies, etc)
English Achievement
Date / Course/ Test / Grade
TEACHER / PARENT / GUARDIAN
Name of Parent / Guardian
Correspondence Address:
Telephone No.
Mobile-phone No. / Fax No.
CHECKLIST OF SUPPORTING DOCUMENTS REQUIRED AND TO BE ATTACHED TO THE COMPLETED APPLICATION FORM
Two (2) copies of passport-sized photograph
Photocopy of the passport pages containing details on passport number, personal particulars and photograph (International students only)
Photocopy of both sides of the National Identity Card
Photocopy of the Birth Certificate
Certified true copies of all certificates and relevant examination results
Letter of reference (MA and PhD students only)
Personal medical health report (Degree students only)
Certified copy of Monk / Nun Identity Certificate/Card (Ordained persons only)
Guaranteed letter on good character by the abbot of a temple or a state official
DECLARATION
I, ………………………………………………………………………………………………………………………………… (name) hereby declare that all information in this form is complete and correct.
I also agree to:
· abide by the SIBA rules and regulations at all times;
· pay all fees as required on arrival;
· accept that SIBA reserves the right to amend and add to existing policies, fees, rules and regulations as it deems fit.
Applicant’s Signature: Date:
FOR OFFICE USE ONLY / Officer / Comments
Date Received: / /
File No.
Application accepted / Yes
No
Date informed: / /
Accommodation offered? / Yes No
Financial support offered? / Yes No
Approval of Admissions Committee - Chair
Approval of Rector
Admission Number
Student Identity Card Number
NOTE: Incomplete application form, documents and uncertified certificates may not be considered.