STUDENT ASSOCIATE APPLICATION FORM                                       

1. Title:

Dr. / Mr. / Mrs. / Ms. / Other

2. Name in Full:

3. NIC No:

4. Date of Birth:

5. Residence Address:

6. Residence Telephone:

7. Mobile No.

8. Present Job Title:

9. Place of Employment and Address

10. Office Telephone:

11. Permanent Email:

12. Alternate Email:

13. Year of MBA Induction and MBA Registration No.

14. Other Professional Qualifications:

15. Applicants must be recommended by a Member of the MBA Alumni Association of the University of Colombo

Members Name:

Life Membership No :

Contact No:

 Attached herewith;

Copy of MBA acceptance letter  Passport size photograph / Digital pic  Payment slip 

If not provided, please mention the reasons.

……………………………………………………………………………………………………………………………..

I hereby apply to be enrolled as a Student Associate of the Association and agree to abide by all rules and regulations.

Signature: _____________________ Date: _______________

Enrollment Fee (valid for 2 years): Rs. 5,000 Extension Fee (for another 2 years): Rs. 5,000 (permitted only once)

A Student Associate becomes eligible to apply for the Life Membership after graduation

Membership fees can be directly deposited to “MBA Alumni Association, University of Colombo”

Current A/C No: 115010135408, HNB, Colpetty Branch.

Official Use only:

Cash/ Cheque :

Receipt No:

Student Associate No: SA/

Date of approval:

Treasurer:

Secretary :

 Faculty of Management & Finance, University of Colombo,

No.94, Kumaratunga Munidasa Mawatha, Colombo 03.

E-mail: info@colombomba.com Web: www.colombomba.com