Association of National Technology – Sri Lanka. Application for the association memberships.

www.nct-tech.edu.lk

 80/3, Malwatta Rd, Hokandara South,Hokandara. T/P: 0773613399 Email: nctassociation@gmil.com                                                                               

 Membership No: _ _ _ _ / _ _ / _ _ _ _ (only for office use)

Applicant’s NIC No: …………………………………….

1. Required associate membership: (a) Student Membership (STM) : ( ) (b) Employee Membership (EMM) : ( ) (c) Honorable Membership (Hon.M) : ( )

 2. Applicant’s relevant Engineering field.

(a) Civil Engineering – CE ( ) (b) Electrical & Electronic Engineering – EE ( ) (C) Mechanical Engineering – ME ( ) (d) Quantity Surveying – QS ( )

       3. Personal details:

3.1 Name in full:…………………………………………………………………………………………………………………………. 

              3.2 Name with initials: …………………………………………………………………………………………………………………. 

              3.3 Date of birth: Date……….. Month: …………… Year: ……………………………… 

3.4 Postal Address: …………………………………………………………………………………

3.5 Contact No: Home …………………………… Mobile: ……………………………………..

3.6 Email address: ………………………………… 

4. Technical / Vocational education background.

Institute Course of study Duration From To 1. 2. 3. 4. 5.   4.1 Index Number of NCT final certificate (for employee members): ...…………………......................... 4.2 Technical College /COT and student’s ID number (for student members): …......................................   5. History of applicant’s careers.

Employer Position held From To 1. 2. 3. 4. 5.

6. Special training programs obtained in relevant technical / vocational field. Yes ( ) No ( )

If yes: ………………………………………………………………………………………………………

7. Educational back ground.

7.1 School attended

(a)

(b)

(c)

(d)

(e)

    7.2 Attended to G.C.E Ordinary Level ( )

7.3 Did you attend to G.C.E Advanced Level Yes ( ), No ( )

If yes 7.3 (a) Bio Science ( )

7.3 (b) Mathematics ( )

7.3 (c) Commerce ( )

7.3 (d) Arts ( )

8. Special activities of applicant: Teaching, Presentation skill, Singing, Dancing, sports, web designing, IT skill, Photographing & etc. ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

 

9. Are you a blood donor? Yes ( ), No ( )

9.1 If yes, your blood group: …………………………..

Note: As a charity service, association plan to help patients who need blood for urgent surgeries and other medical treatments.

Do you like to save valuable lifes, please join us as a blood donor.

Do you like to register as a blood donor on our data base? …………………………………… 

 

10. Declaration: I wish agree to get the membership of Association of National Technology – Sri Lanka as a Student Member/Employee Member/ Honorable Membership from the date of ……………………………….. (Payment date for the membership). All my details are true and correct. And I shall assist to develop & lead the association to higher level and agree to terms & conditions of ANT SL. Date: ………………………………… Signature: …………………...