khztu;fSf;fhd mwpTWj;jy;

1. gjpT nra;Ak; Neuj;jpy; rku;g;gpf;fg;gl Ntz;ba Mtzq;fs;.

i. Kiwahf G+u;j;jp nra;ag;gl Ntz;ba cs;thq;fs; gbtk; (Form B) ,q;Nf

,izf;fg;gl;Ls;sJ.
ii. SLIIT kpd;dQ;ry; Kftupia jtpu;f;fTk; (Form B).
iii. ifnahg;gkplg;gl Ntz;ba gbtk; (Indemnity Form C)
iv. khztu; gjpT ,yf;fj;ij jtpu;f;fTk; (Form C).
v. ngw;Nwhu; my;yJ ghJfhtyu; rhl;rpfSf;fhf ifnahg;gkplyhk; (Form C).
vi. f.ngh.j cau;jug;guPl;ir kw;Wk; f.ngh.j rhjhuzju guPl;ir ngWNgw;W
rhd;wpjopd; mry; gpujp (Original) cl;gl A4 mstpyhd epuy; gpujp(Photocopy)
xd;Wk; rku;g;gpf;fg;gl Ntz;Lk;.
f.ngh.j cau;jug; guPl;ir rhd;wpjo; ,d;Dk; fpilf;fg;ngwtpy;iy vdpy;>
Kiwahf epug;gl;l Advanced level completion (Form D) nfhz;L thUq;fs;.
vii. guPl;irfspd; mry;(Original) rhd;wpjo;fs; cq;fsplk; ,y;iynad;why;>
,iza efy;fSld;(Internet copies) mry; rhd;wpjy;fis rku;g;gpf;ff; $ba
jpfjpiaf; Fwpg;gpLk; fbjj;ijAk; ,izf;fTk; (Form D).
viii. cq;fs; cau; fy;tpj;jFjp tptuq;fis vOJq;fs; (A/L my;yJ O/L)
(Form D).
ix. gpwg;G rhd;wpjopd; mry; kw;Wk; A4 mstpyhd epuy; gpujp xd;W.
x. cq;fs; rkPgj;jpa Gifg;glj;jpd; ,uz;L epug;gpujpfs; (35mm x 45mm) cq;fs;
KOg;ngaUld; KjnyOj;Jf;fs; kw;Wk; milahs ml;il ,yf;fj;Jld;
rku;g;gpf;fg;gl Ntz;Lk;;. xU Gifg;glk; Gifg;gl ];Nfdpq; jhspy; (Photo
Scanning Sheet) xl;lg;gl Ntz;Lk; (Form E).
xi. Njrpa milahs ml;il kw;Wk; mjd; A4 mstpyhd xU efy; gpujp.
xii. Kjy; nrkp];lu; ghlnewp fl;lzj;jpw;fhd gw;Wr;rPl;L.

ePqf
; s; Foundation Program Kbj;jpUe;jhy; mjd; gjpT ,yf;fj;ij
(Registration number) Fwpg;gplTk;.

2. fl;lzk; nrYj;Jk; topKiwfs;

i. cq;fs; nrkp];lu; kw;Wk; gjpT fl;lzj;ij KOikahf “SLIIT Academy

(Pvt) Ltd” vd;wthW fPNo gl;bayplg;gl;l tq;fpfspd; ve;j fpisfspYk;
nrYj;jyhk;.
a. ,yq;if tq;fp fzf;F ,y 1630 619
b. rk;gj; fzf;F ,y 0134 1000 1688
c. Ne\d;]; l;u];l; fzf;F ,y 1003 8000 5430
d. \l;ld; ne\dy; fzf;F ,y 701010012815

ii. fld; ml;il(Credit card) tuT/ml;il(Debit card) nfhLg;gdTfs;

mYtyfj;jpy; cs;s POS ,ae;jpuq;fs; topahf Visa/Master ml;ilfs; vdpy;
1.53% my;yJ Amex ml;ilfs; vdpy; 2.05% $Ljy; fl;lzj;Jld;
Vw;Wf;nfhs;sg;gLk;.

iii. NkNy Fwpg;gpl;l tq;fpf; fzf;Ffspy; Md;iyd; gzg; gupkhw;wq;fSk;

Vw;Wf;nfhs;sg;gLk;.
 Declaration Form

I’m ................................................................... registering with my results at the G.C.E (O/L)/ G.C.E (A/L)
Examination (Pending/Completed).

I shall submit my O/L/,A/L results immediately after the release of results. I am aware that I should have the
following G.C.E (A/L) or G.C.E (O/L) Qualifications to continue the program.

• Minimum of 1 Simple pass at one and the same sitting (out of three subjects)in G.C.E (A/L) and
minimum of a Credit pass for General English in G.C.E (O/L) for SLIIT CITY UNI Higher Diploma in
Information Technology/Business Programmes prior to the commencement.

• Upon the successful completion of the IT Higher Diploma, the students are eligible to apply for the final
year Top Up Degrees in BSc (Hons) Computer Science & Software Engineering and BSc (Hons) Computer
Networking offered by University of Bedfordshire UK.

• Upon the successful completion of the Business Higher Diploma, students are eligible to apply for the
final year Top Up Degree in BA (Hons) Business Administration offered by University of Bedfordshire UK.

• Minimum of 3 Simple passes at one and the same sitting from Maths and Bio streams in G.C.E (A/L)
and minimum of a Credit pass for General English in G.C.E (O/L) for SLIIT CITY UNI Higher Diploma in
Electronic & Electrical Engineering prior to the commencement. Upon the successful completion of the
Higher Diploma in Estudents are eligible to apply for the final year top up Degree offered by Liverpool John
Moores University UK

• Upon the successful completion of the Engineering Higher Diploma, students are eligible to apply for the
final year Top Up Degree in BEng (Hons) Electrinics and Electrical Engineering program offered by the
Liverpool John Moores University.

• Possession of six passes including Credit passes for Mathematics and English at the G.C.E Ordinary Level
(Sri Lanka/London)obtained at one and the same sitting for Foundation Certificate in Information
Technology/ Business Management at SLIIT CITY UNI.
• Possession of six passes including Credit passes for Mathematics, English and Science at the G.C.E
Ordinary Level (Sri Lanka/London)obtained at one and the same sitting for Foundation Certificate in
Engineering/ Health & Life Sceiences at SLIIT CITY UNI.

• Possession of six passes including Credit passes for Mathematics & English at the G.C.E Ordinary Level
examination in Sri Lanka or five passes including Credit passes for Mathematics & English in London O/L
examination obtained at one and the same sitting for CURTIN University — SLIIT CITY UNI Foundation
Programmes in Information Technology/Business

• Possession of six passes including Credit passes for Mathematics, English and Science at the G.C.EOrdinary
Level (Sri Lanka/London) obtained at one and the same sitting for CURTIN University — SLIIT CITY UNI
Foundation Programmes in Health and Life Sciences/ Engineering

Date: …………………………………… Signature: …………………………………………

 ENROLMENT FORM
SLIIT CITY UNI
JULY INTAKE 2024

PERSONAL DETAILS
Name with initials

Name in Full:
(BLOCK CAPITALS)
( WITH ONE LETTER
IN A CAGE)
For Exomple
I do hereby confirm that the above name is
correct and I am aware that this name will
be used in all the certificates and transcripts
issued by the institute.

National Identity Card No: Passport Number :

Date of Birth : DD/MM/YYYY Right Hander Left Hander

Gender : Male Female

CONTACT DETAILS :

Name of Parent/Guardian: Student Conta ct No. (Home):

Contact No. Parent/Guardian (Home) (Mobile)

(Mobile)

I give my consent to share my academic progress

details with my parents/guardian

Parent/Guardian’s Personal Email Student Personal Email

Present Postal Address Country Province District

Ex : Sri Lanka Ex : Northern Ex: Ampara

Same as above Permanent

SLIIT Email ......................................................................... @ my.sIiit.Ik
Address
Ex: RegistrationNo@ my.sIiit.Ik

Same as above
Parent/Guardian’s Postal Address
EDUCATIONAL QUALIFICATIONS:

G.C.E. ADVANCED LEVEL (A/L) RESULTS

Year : Index Number :

Z Score : School Attended

A/L Status Curriculum

Completed Pending Incomplete Local London Cambridge Other

Medium Stream

Sinhala English Tamil Ex : Commerce

Attempt Number of Passed Subjects

Ex : 1" 0 1 2 3 4

District Subjects at One Sitting (If results are pending please indicate “Pending” as
the grade )
Subject Grade Subject Grade
1. 3.
2. 4.
G.C.E. ORDINARY LEVEL (O/L) RESULT
Grade Curriculum
English Language Mathematics
Local London Cambridge Other
 Programme Selection FORM A. 1

SLIIT CITY UNI Degree Programmes

Please tick ( √) the appropriate box to choose the relevant programme/ specialization & the location
SLIIT
SLIIT CITY UNI
CITY UNI
Colombo Colombo Kandy Mathara Jaffna Kurunegala

WD WE WD WD WD WD
Foundation Certificate in Information Technology- SLIIT CITY UNI UOB
pathway
Foundation Certificate in Business Management - SLIIT CITY UNI UOB
pathway
Foundation Certificate in Health & Life Sciences (Psychology) - SLIIT CITY
UNI LJMU UK pathway
Foundation Certificate in Electronic & Electrical Engineering - SLIIT CITY
UNI - LJMU UK pathway
Foundation Certificate in Health & Life Sciences (Nursing) - SLIIT CITY
UNI -Deakin University Australian pathway
Curtin University - SLIIT CITY UNI Foundation programmes Specialization
in IT
Curtin University - SLIIT CITY UNI Foundation programmes Specialization
in BM

Curtin University - SLIIT CITY UNI Foundation programmes Specializationin

Engineering

Curtin University - SLIIT CITY UNI Foundation programmes Specialization

in HS

BSc(Hons) Computer Science & Software Engineering - UOB (UK) First Year Only First Year Only First Year Only

BSc(Hons) Computer Networking - UOB (UK) First Year Only First Year Only First Year Only

BA(Hons) Business Administration - UOB (UK)

BEng(Hons) Electronic & Electrical Engineering - LJMU (UK)

Available Not Available

 FORM A. 2

PAYMENT DETAILS

Payment Type Date of Payment Bank Branch

Full Payment

Deposited Amount

** I am also aware that Examinations would be conducted during Weekends and Weekdays.

The following documents are attached with this form. (Please tick (/) in the appropriate cage)

Signed Offer of Admission Photocopy of National Identity Card Received

G.C.E (A/L) Results Sheet Received Birth Certificate Received
G.C.E (O/L) Results Sheet Received Photographs (2 copies) Received
Received Payment Receipt Received
Payment Receipt (Rs. )

I cert’ify that the above information provided by me is authentic

Date: ....................................... Signature: .......................................................................

For Office Use Only

Aptitude Test Index No:.....................................

Signed Offer of Admission Photocopy of National Identity Card Received

G.C.E (A/L) Results SheetReceived/Not Received Birth Certificate Received

G.C.E (O/L) Results SheetReceived/Not Received Photographs (2 copies) Received

Payment Receipt Received/Not Received

This is to certify that Rev. / Mr. / Ms .......................................................................................... has been enrolled as a student of the SLIIT CITY UNI for the Degree

Programme —

Date: ................................... Name of Officer Handling: ........................................... Signature: ..................................................................

 Form B
DECLARATION OF EXCLUSION OF LIABILITY AND
INDEMNITY
SLIIT CITY UNI (Pvt) Ltd.)

Student Full Name …………………………………………………………………………………………………….

Application Number: ………. Program:…………………………..….. N.I.C. /Passport No.: ………………………

I, being a “Student” who participates in and/or observes the “activities” of SLIIT CITY UNI, in its Campuses and/ or
Centers, whether conducted at the Institute and/or extramurally, including, but not limited to, studies, field trips, games,
athletics, recreational/ competitive sports tours, cultural/social events, competitions, excursions of general vocational,
educational, historical, social or scientific interest, make the following declarations which are deemed to be conditions
under which my participation and/or observation takes place.

1. I fully understand and accept that participation and /or observation in all such “activities” for all intents and purposes will
be at my/our own risk.

2. I hereby authorise the Institute and its employees or agents to act on my/our behalf in respect of any circumstances pertaining
to any accident, illness, or death arising from, during, or in connection with such “activities” in the manner that the
Institute, its employees, and agents in its absolute discretion deem fit. I/we fully accept the full liability for all expenses
incurred thereby or in connection therewith.
3. I hereby fully and forever discharge and release SLIIT CITY UNI from any and all liability, loss, claims, demands,
actions cost of any proceedings instituted and causes of action whatsoever arising out of any damages, both in law and in
equity, arising from the said “activities,” including but not limited to equipment and training that may arise in the course
of, or in connection with, associated with the activities. Exemption from liability includes loss, damage, or injury
resulting from the negligence of or from any other cause or causes.

4. I agree to indemnify and hold the Institute, its officers, agents, and employees, any person/s acting on its behalf, or invitees
fully absolved and harmless from any liability, loss or damage they may suffer as a result of claims, demands, costs or
judgments against them arising out of the activities to be carried out/ observed by myself/others to the obligations of
activities; provided, however, that any such liability, loss or damage resulting from the following subsections “a,” “b” “c”
“d”and or “e” is/are excluded from this declaration to indemnify and hold harmless:
a. Injuries caused by myself to other students and/or their peers and visitors of in the campus/centers and/or
extramurally causing SLIIT CITY UNI to be liable for the injured students and/or visitors.
b. Injuries to other students and/or their peers and/or visitors on the campus by my friends / invited visitors causing
SLIIT CITY UNI to become liable for the injured students and/or visitors.
c. damages to the property of the Institute by myself
d. damages to the property of outside Institutions during/when they represent the Institute and participate in academic
and/or non-academic (sports/recreational/extracurricular) activities

5. I further undertake to comply with any rule or regulations of the Institute relating to its Code of Conduct, safety, and/or
other obligations under prevalent laws of Occupational Health and Safety matters. Any Act or similar legislation in Sri
Lanka as well as any reasonable instructions given by any official of the Institute relating to the aforesaid. I fully and
forever discharge and release SLIIT CITY UNI from any and all liability that may arise from gross negligence on my
part.
6. This declaration absolving indemnity will operate as a valid declaration and document and continue to be in
force and cover all periods of attendance as a student of the Institute.

………………………………………………
SIGNATURE OF “STUDENT”

SIGNED AT (home address) ………………………………………………………..ON (Date)……………………….

I/We witness the signing of the above declaration by “Student”.

WITNESSES (Name, NIC No, Signature)

1.…………………………………………………………………………………………………………………
(Name) ( NIC) ( Signature)

2………………………………………………………………………………………………………………….
(Name) ( NIC) ( Signature)
 EDUCATIONAL QUALIFICATION FORM C

Student’s Address : ………………………………………….

………………………………………………….

………………………………………………….

G.C.E. ORDINARY LEVEL (O/L)

02. O/LIndexNo:

03. Year :

04. ExamCentre:

05. Passes :

G.C.E. ADVANCE LEVEL (A/L)

Pending

………………………………………
02. A/L Index no:

03. Year : ……………………

04. Exam Centre : ………………………………………

05. Stream : ………………………………..

06. Passes : Subject 1 ………………… Subject 3 …………………

Subject 2 ………………… Subject 4 …………………

Icertify that the particulars given above are true andcorrect.Iwill submit my O/L or A/LExaminationresultsimmediately after the release of results.

Date : ……………………………………. Signature :…………………………

Please paste 3.5 cm x 4.5 cm applicant photograph in the above box.
Name:...............................................................................................
Refund Policy

Refund of fees paid

Students shall be entitled to request refund of Tuition and Repeat Examination after submitting the refund application form along with proof of payment.
Refund will be made in accordance with the SLIIT CITY UNI refund policy described below

Tuition Fees

I. Applications who have not followed the course for more than one week - A refund of 90% of the payment shall be made provided the lesson material
and SLIIT CITY UNI student identity card are returned to the Academic Affairs Division.

For purpose of refund of the first year first semester fee the date of commencement of the orientation programme, will be reckoned as the date of
commencement of the study programme.
If and when the Orientation program has not been attended it will be the date of commencement of the Study Programme.

II. Applicants who have followed the course for less than one month - A refund of 50% of the payment shall be made provided the lesson material and
SLIIT CITY UNI Student Identity Card are returned to the Academic Affairs Division.

III. No refund after one month.

IV. Registration fee of LKR 10,250 is a non-refundabel payment.

I agree with the above terms and conditions.

Name ..............................................................

NIC / Passport Number ..............................................................

Date ............../.........../......................................

Signature ............................................................ .