For Office Use Only

DEPARTMENT OF CIVIL ENGINEERING

FACULTY OF ENGINEERING
UNIVERSITY OF PERADENIYA

POSTGRADUATE PROGRAMMES IN CIVIL ENGINEERING

APPLICATION FOR ADMISSION – 202_

1. NATIONAL ID / PASSPORT NO :

Mr./ Ms/ Dr. (Delete whichever is not applicable)

NAME WITH INITIALS:

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NAMES DENOTED BY INITIALS:

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EMAIL:

2. HOME ADDRESS: ----------------------------------------------------------------------------------------------------------

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Telephone: Mobile No:

OFFICIAL ADDRESS:

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Telephone: Mobile No:

ADDRESS FOR CORRESPONDENCE (Home/Official)

Assistant Registrar should be informed of any changes immediately

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 certificates 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 MSc. MSc.Eng.

10.2 Programme of study (Enter 1-5 in the order of preference, if applicable)

Geotechnical Engineering

Highway and Traffic Engineering

Structural Engineering

Sustainable Built Environment

Environmental and Water Engineering

11. DOCUMENTS TO BE INCLUDED WITH THE APPLICATION:

a. Two Referee Reports (at least one should be from the applicant’s teacher at university)
b. Degree/Diploma certificate/s (Photocopy/ copies)*
c. Academic Transcript/s (Photocopy/ copies)*
d. Birth certificate (Photocopy)*
e. NIC (Photocopy )*
f. 2 self-addressed envelopes (22cm x 10cm) with Rs.15/= Stamp affixed.
g. Proof of (Deposit slip) of the payment of application processing fee.

Note: * Originals should 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 be your teacher at
the University)

Name: Name:

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Address: Address:

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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 program of
Civil Engineering under confidential cover. Alternatively, signed and sealed envelopes may 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 a program of study I have applied for, I hereby agree to
abide by such Rules and Regulations of the Institute as are applicable to me.

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Date Signature of Applicant

Perfected application in duplicate with supporting documents to be sent under Registered Post to
Assistant Registrar, Faculty of Engineering, University of Peradeniya, along with proof of
payment of Rs. 1,000/= to the below account as the non-refundable application processing fee.

Bank Details
Bank : Bank of Ceylon
Branch : Peradeniya
Name of Account : Research and Fund Account
Account Number : 0001274688

Please indicate “PG/Civil Engineering” on the top left hand corner of the envelope.

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Date :

To : ALL APPLICANTS OF THE POSTGRADUATE PROGRAMMES 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 in the degree certificate to be awarded to you at the time of graduation.

Name of the Applicant : ------------------------------------------------------------------

Signature of Applicant : -------------------------------------------------------------------

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 programme 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 a female candidate could make a request to change her name
after the marriage. In such a case, those candidates are required to submit a certified copy of the
marriage certificate for our reference.

Assistant Registrar/ Faculty of Engineering

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 POSTGRADUATE PROGRAMMES IN CIVIL ENGINEERING

REFEREE’S REPORT – 202_

SECTION ‘A’ (To be completed by the Candidate)

REFEREE APPLICANT

Name: …………………………….. Full Name of Applicant:

Title: ……………………………… ………………………………………
Institution: ………………………… ………………………………………

Degree Programme applied for :………………………………………………………………...

I, ……………………………………………………………………(name) hereby waive my right of

access to this reference report.

Signature of Applicant : ………………………………………..

(To be signed by applicant before handing this form to the referee).

SECTION ‘B’ (To be completed by the Referee)

Please tick the appropriate Box (Boxes) below to indicate your level of association with the
applicant.

a This student was enrolled in my class/es

b I was this student’s undergraduate/ Project/ Research advisor

While I have not taught or advised the applicant, I have known the
c
applicant for …………… years.
d I supervised or directed the work of the applicant for ………years.

e I do not know this individual well enough to evaluate.

In the space below or as an attachment, please add any comments which will assist in our making a
judgment as to whether the applicant should be admitted to the programme of study applied for.
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

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Please evaluate the applicant by placing a tick (√) after each characteristic that most nearly represents
your opinion. Compare the applicant with a representative group of students qualified for graduate
study whom you have known and who have had approximately the same amount of experience and
training as the applicant. If you lack knowledge to make a definite rating, give your estimate of
applicant’s ability, by checking the last column.

Inadequate
Below Superior
Average Good Opportunity to
Average (Top 10%)
Observe
a. Ability to master academic
work
b. Ability in oral expression in
English
c. Ability in written
expression in English

d. Motivation

e. Emotional stability and

maturity
f. Self-resilience and
independence

Signature of Respondent Date

Please enclose the confidential report in an envelope and sign after sealing it. The envelope sealed and
signed may be handed over to the applicant who is required to mail it along with his/her application.
If you prefer, you may mail this Referee’s Report directly to the address given below to reach on or
before 16-11-2020.

Programme Coordinator
Postgraduate Programme in Civil Engineering,
Faculty of Engineering,
University of Peradeniya,
Peradeniya.

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