G.C.E. (A/L) Examination 2021(2022)

Application for Selection of Examination for Practical Boards

TIP! First fill the NIC number.

1 Personal Information Details about yourself

NIC No.: * A value is.

Title: * Please select an item.

Full Name: * A value is required.

Telephone No. (Mobile ): * A value is required.

Residential Telephone No. :

Telephone No. (Office):

Email Address :

Private Address

Home Address: * A value is required.

Street Address:

Postal Town:* A value is required.

Office Address

Office Address: * A value is required.

Street Address (Office):

Postal Town (Office)*: A value is required.

2Subject Preferences and Previous Year Information Tell us about your practical subject preferences and previous year information

Preferred Medium: *

Please select an item.

Corresponding practical subject:*

Please select an item.Please select a valid item.

Expected position/ positions: *

Please select a valid item.Please select an item.

Subject field: *

Please select a valid item.Please select an item.

If you have served at a practical examination board in the year 2020

District Served

Name of the board

Board No.

Present working District:* Please select a valid item.Please select an item.

Permanent residence District :* Please select a valid item.Please select an item.

District you wish to work:

First Choice* Please select a valid item.Please select an item.

Second Choice

Third Choice

(District serving at present and residing district except the district served in the year 2020)

In case the above districts could not be granted, would you wish to work in any other district of the island?*

Yes No

3 Other Details Some more details

Other Information

Do you/ a family member / a resident of your house expects to sit this examination this year?*

Is any disciplinary inquiry being conducted against you ?*

4Declaration of the ApplicantPlease verify your declaration

I hereby declare that the information given above is true and accurate and that I am not debarred from examination duties at present and I am aware that I will be subjected to disciplinary actions if found to have submitted false information and mislead the department. If I am selected as a practical board examiner, I agree to safeguard the dignity of the institution where the practical tests will be established and abide by its rules and regulations of the institution, and follow the provisions of the Public Examinations Act as well as the instructions given by the Commissioner General of Examinations and abide by the code of ethics for practical examination staff.

I agree* Please make a selection.