we.hSï lghq;=j, ksr; úh yels NdId udOHh isxy, fou< bx.S%is kjpg;gPL nra;a tpUk;Gk; nkhop%%yk; rpq;fsk; jkpo; Mq;fpyk;

Preferred language of marking Sinhala Tamil English

01' ,l=Kq lsÍug b,a¨ï lrk úIh wxlh yd úIhh Gs;spapl tpz;zg;gpf;Fk; ghl vz;Zk; ghlKk;

Subject No. & subject applied for marking

02' we.hSï lghq;=j, ksr; ùug leu;s k.r wxlh yd k.rh ( ^07 msgqfõ i`oyka k.r f,aLkh n,kak'&$kjpg;gPl;Lf; flikapy; <Lgl

tpUk;Gk; efu vz;Zk; efuKk;: ( 7 Mk; gf;fj;jpYs;s efug; gl;baiyg; ghu;f;fTk;.)$Town No. and town you wish to do marking : (Please see the list of towns given on page 08.) (i) m<uq f;aÍu$KjyhtJ njupT$First choice ( (ii) fojk f;aÍu$,uz;lhtJ njupT$Second choice (

03' (i) uq,l=re iu`. ku$KjnyOj;Jf;fSld; ngau; : $Name with initials :

mQQcH$jpU/jpUkjp/nry;tp: Rev./Mr./Ms. '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' ysñ$uhd$ñh$fukúh

(ii) uq,l=rej,ska ye`Èkafjk kï ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

KjnyOj;Jf;fshy; Fwpf;fg;gLk; ngau;fs; ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

Names denoted by initials ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

(iii) ,smskh$Kftup$Address ( ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

(iv) úoHq;a ;eme,a ,smskh$kpd;dQ;ry; Kftup $E - mail address (

(v) ia;S%%$ mqreI Ndjh$ghy; -Mz; $ngz; $Gender (

(vi) cd;sl ye`ÿkqïm;a wxlh$Njrpa m.m.vz;$National identity card No. (

04' (i) ±kg fiajh lrk Èia;s%%lalh$jw;NghJ Nritahw;Wk; khtl;lk; $District working at present(

(ii) wOHdmk l,dmh$fy;tp tyak; $Education zone (

(iii) iaÓr mÈxÑ Èia;s%%lalh yd ,smskh

epue;ju tjptpl khtl;lKk; KftupAk;

Permanent residential district and address

wjika jrg fiajh l<$,Wjpahf gzpahw;wpa$Last Served

j¾Ih$tUlk;$Year k.rh$efuk;$Town

ixfla; wxlh$FwpaPl;L ,yf;fk;$Code No.

iïmQQ¾K lsÍug fmr 07 msgqfõ we;s Wmfoia yd 03 ^01& 2009 pl%%f,aL Wmfoia lshjkak'g+uzg;gLj;Jtjw;F Kd;du; 07Mk; 08Mk; gf;fj;jpYs;s mwpTWj;jy;fisAk; 03 ^01& 2009 Mk; ,yf;f Rw;W epUg mwpTWj;jy;fisAk; thrpf;fTk;.

Please read the instructions given on page 08 and in Circular No.03 (01) 2009 before completing. fuu úNd.h i`oyd whÿïlrejl=f.a orejl= fyda mjqf,a idudcslhl= fyda fkajdislhl= fyda bÈßm;a jkafka kï whÿïlreg m%%Odk$w;sf¾l m%Odk mÍCIl Oqrhla i`oyd b,a ï l< fkdyel'jdJ gps;isNah> FLk;g cWg;gpdNuh tPl;by; trpg;gtNuh ,g;guPl;irf;Fj; Njhw;wtpUg;gpd;

tpz;zg;gjhuu;; gpujk $ Nkyjpf gpujk guPl;rfu; gjtpf;F tpz;zg;gpf;f KbahJ.

If a child, a family member or a resident of an applicant is sitting this examination, he/she cannot apply for the post of Chief/ Additional Chief Examiner.

wiïmQQr®K f;dr;=re iys; b,aÆïm;%% m%%;sfCIam lrkq ,efí'

g+uzkw;w tpz;zg;gg;gbtq;fs; epuhfupf;fg;gLk;.

Incomplete applications will be rejected.A/L

2018 ,l=Kq ixfla; wxlh Gs;spfs; FwpaPl;L vz;

Marks Code No.

ldr®hd,hSh m%fhdackh i|yd mYtyfg; gad;ghl;bw;fhf

FOR OFFICE USE

m¯CIljrhd úiska iïmQr®K l< hq;= h'guPl;rfupdhy; g+uzg;gLj;jg;gl Ntz;Lk;.

To be filled by the examiner.

w'fmd'i' ^W'fm<& úNd.h - 2018f.ngh.j. (cau; ju)g; guPl;ir - 2018

G.C.E. (A/L) Examination - 2018 W;a;rm;%% m¯CIljreka f;dard.ekSu i`oyd b,aÆïm;%%h

tpilj;jhs; Gs;spapLk; guPl;rfu;fisj; njupT nra;tjw;fhd tpz;zg;gg;gbtk;Application for Selection of Marking Examiners

b,a¨ïm;% túh hq;= wjidk Èkh 2018 wfma%%,a ui 30 fõ'

tpz;zg;gg;gbtq;fis mDg;g Ntz;ba ,Wjpj; jpdk; 2018.04.30 Mk; jpfjpahFk;.

Closing date of applications is 30 th April 2018.

whÿïm;%%h bx.S%%is NdIdfjka iïmQQ¾K lrkak'tpz;zg;gg;gbtj;ij Mq;fpyj;jpy; g+uzg;gLj;jTk;.

Please fill the application in English

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^wod< fldgqj, ^√& ,l=K fhdokak'& (Fwpj;j $l;by; ^√& milahskpLf.)

(Tick ( Ã ) the relevant box.)

''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

05' (bx.S%%is lemsg,a wl=frka$ Mq;fpy nfg;gpl;ly; vOj;jpy;$IN BLOCK LETTERS) ku$ngau; $Name ( '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' ,smskh$Kftup $Address -

rdcldß$mYtyfk;$Official ( fm!oa.,sl$jdpg;gl;l $Private ( ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

ÿrl:k wxl$njhiyNgrp vz;$Telephone Nos. ( rdcldß$mYtyfk; $Official ( ksji$tjptplk;$Home ( cx.u$nry;ypl$Mobile (

06' (i) ±kg ork ;k;=r jw;NghJ tfpf;Fk; gjtp ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' Present Designation (ii) wh;ajk fiAjh yd fYa%%Ks◊h NritAk; juKk; ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' Service & grade

07' (i) Wmka Èkh gpwe;j jpfjp

Date of birth

(ii) 2018'08'31 Èkg jhi 2018.08.31 ,y; taJ

Age as at 31.08.2018

08' .=rejrhl= jYfhka m;aùu ,;a Èkh Mrpupauhf Kjy; epakdk; ngw;w jpfjp

Date of appointment as a teacher

09' WmdêOdß .=rejrhl= jYfhka úêu;a m;aùu ,;a Èkh gl;ljhup Mrpupauhf epakdk; ngw;w jpfjp

Date of appointment as a graduate teacher(

10' (i) Wmdê .=re m;aùfuka miq fiajd ld,h wjqreÿ gl;ljhup epakdj;jpd; gpd; Nritf;fhyk; tUlq;fs;

Period of service after being appointed as a graduate teacher Years

(ii) wOHdmk ämaf,daud fyda Bg iudk fjk;a mYapd;a WmdêOrhl= jYfhka fiajd ld,h wjqreÿ fy;tp bg;Nshkh my;yJ mjw;Fr; rkkhd gl;lg;gpd; gbg;G gl;ljhupahf Nritf;fhyk; Mz;Lfs; tUlq;fs;

Period of service as a holder of Postgraduate Diploma in Education or a similar qualification: Years

11' (i) wOHdmk" jD;a;Sh iqÿiqlï$fy;tp> njhopy;> jifikfs;$Academic, Professional qualifications: ^fuu fldgi ksjerÈj iïmQQ¾K fkdl< b,a¨ïm;%% m%%;sfCIam lrkq ,efí'&(,g;gFjpia rupahf g+uzg;gLj;jhjtplj;J ,g;gbtk;

epuhfupf;fg;gLk;.) (If this section is incomplete, the application will be rejected.)

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D D M M Y Y Y Y

D D M M Y Y Y Y

D D M M Y Y Y Y

Y Y

Y Y

Y Y M M D D

02

wOHdmk$ jD;a;Sh$ fjk;a iqÿiqlï

fy;tp/ njhopy;/NtW

jifikfs;

Academic/ Professional/ Other Qualifications

mdGud,dj ghlnewp

CourseFollowed

iu;a j¾Ih Nju;r;rp

ngw;w fy;tp

Mz;L

Year Completed

iu;a úIhka ^úIhka i`oyka lsrSu

wksjd¾hhs&rpj;jpaile;j ghlq;fs;

(ghlq;fisf; Fwpg;gpLtJ

fl;lhakhdjhFk; )

Subjects Passed(Compulsory to state subjects)

iu;a mka;sh

^wef;d;a&ngw;w

tFg;G

(,Ug;gpd; )

Class Received (If any)

úfYaI

idu¾:H

^wef;d;a&

tpNrl rpj;jpfs;

(,Ug;gpd; )

Special Passes(If any)

úYajúoHd,h$

wdh;kh

gy;fiyf;fofk;/epWtdj;jpd; ngau;

Name of the University/ Institution

b,a¨ï lrk úIhhg wod< mqyqKqjtpz;zg;gpf;Fk; ghlj;jpw;Fupa gapw;rp

Training relevant to the subject applied

b,a¨ï lrk úIhhg wod< Wmdêtpz;zg;gpf;Fk; ghlj;jpw;Fupa gl;lk; Degrees relevant to the subject applied

mYapd;a Wmdê ämaf,daudjgl;lg;gpd; bg;Nshkh

Postgraduate Diploma

by; i`oyka fkdjk fjk;a iqÿiqlï we;akïNkw;Fwpg;gpl;lit jtpu;e;j NtW

jifikfs;

Any other qualifications(if any)

Tn b,aÆï lrk úIhg wod< Wmdê iy;slfha$ämaf,daud iy;slfha iy;sl lrk ,o msgm;la wuqKkaktpz;zg;gpf;Fk; ghlj;jpw;Fupa gl;lg;gbg;G /bg;Nshkh rhd;wpjo;fspd; cWjpg;gLj;jg;gl;l gpujpia ,j;Jld; ,izj;J mDg;Gf.

Please attach a certified copy of the Degree/Diploma certificate relevant to the applied subject.

(ii) úIhh ms<sn`o cd;sl uÜgfï ls%%hdldrlïj, ksr; ù we;akï tajd fláfhka i`oyka lrkak' Wod ( fm<fmd;a" .=re

ud¾f.damfoaY ix.%y" uQQ,dlD;s m%Yak m;% ieliSu" we.hSï jd¾;d ieliSu" úIhdkqnoaO fmd;a m<lsÍu hkdÈhg

±la jQQ odhl;ajh ^,sms msgm;a wuqKkak&'

Gs;spapl tpz;zg;gpj;Js;s ghlk; njhlu;ghf Njrpakl;lj;jpy; jq;fshy; Mw;wg;gLk; fy;tpg; gzpfs; VJk; ,Ug;gpd; RUf;fkhff;

Fwpg;gplTk;. c+k; : ghlg;Gj;jfk;/Mrpupau; ife;E}y;/ Kd;khjpup tpdhj;jhs; jahupj;jy;> kjpg;gPl;lwpf;if jahupj;jy;> ghlj;Jld; njhlu;ghd

gpuRuq;fs; ntspaply; Nghd;wd. ( miog;Gf; fbjj;jpd; gpujpfis ,izf;fTk; ).

State in brief, If you have participated in national level activities related to the subject. Eg. Contribution to prepare Text Books/ Teacher's Guides, Prototype question papers, Evaluation Reports or publication of subject-related books (Please attach relevant letters).

'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

12' Tnf.a rdcldß lghq;=j,g wod< mßÈ 12 (i), (ii), (iii) fldgiaj, f;dr;=re iïmQQ¾K lrkak'

jq;fsJ cj;jpNahff; flikfSf;Fg; nghUe;Jk; tpjj;jpy; 12 (i), (ii), (iii) gpupTfSf;Fupa tpguq;fisg; G+uzg;gLj;Jf.

Fill in 12(i), (ii), (iii) according to your duties.

(i) .=rejreka yd lÓldpd¾hjreka i`oyd$Mrpupau;fSf;Fk; tpupTiuahsu;fSf;Fk;$For teachers and lecturers. (a)

2018 jr®Ih i`oyd wkqu; lrk ,o Tfí iïmQQr®K fm!oa.,sl ld, igyk ^úIhka yd fY%%a◊s we;=Ωj&bx.S%is udOHfhka b.ekaùï lghq;= lrkafka kï úIh iu. E wl=r igyka lrkak

2018 Mk; Mz;by; mDkjpf;fg;gl;Ls;s jq;fsJ KOikahd jdpg;gl;l Neu#rpiag; G+uzkhff; Fwpg;gpLf. ( ghlq;fisAk; juq;fisAk; cs;slf;fpajhf )

Mq;fpy nkhop%yk; fw;gpf;Fk; ghlq;fSf;nfjpNu E vdf; Fwpg;gpLf.

Complete personal time table for year 2018 (with Subjects & Grades)

Write E along with the subject, if you teach in English medium

fõ,djNeuk; Time

i`ÿodjpq;fs;

Monday

w`.yrejdod nrt;tha;

Tuesday

nododGjd;

Wednesday

n%%yiam;skaod tpahod;

Thursday

isl=rdodnts;sp Friday

úIhhghlk;

Subject

fY%%a◊Kshjuk;

Grade

úIhhghlk;

Subject

fY%%a◊Kshjuk;

Grade

úIhhghlk;

Subject

fY%%a◊Kshjuk;

Grade

úIhhghlk;

Subject

fY%%a◊Kshjuk;

Grade

úIhhghlk;

Subject

fY%%a◊Kshjuk;

Grade

03

(b) ,l=Kq lsÍug b,a¨ï lrk úIhh w'fmd'i' ^W'fm<& fY%%a◊◊‚j, i;shlg W.kajk ld,mßÉfþo .Kk (

Gs;spapl tpz;zg;gpj;Js;s ghlj;jpy; f.ngh.j.(c.j) juq;fspy; thuk; xd;wpy; fw;gpf;Fk; ghlNtisfs;

No. of periods the subject applied is taught in the G.C.E. (A/L) classes per week:

12 fY%%a◊Ksh$juk; 12$Grade 12

13 fY%%a◊Ksh ^m<uq jr&$juk; 13 ( Kjy; Kiw )$Grade 13 (First time)

uqΩ¿ ld,mßÉfþo .Kk$nkhj;j ghlNtisfs;$Total No. of periods

idjoH ld, igyka b†˙m;a ls¯fuka j<lsk f,i ;rfha Wmfoia foñ' tfia b†˙m;a lrkq ,nk .=rejrekag yd wdh;k m%%OdkSkag úreoaOj úkhdkql+,j ls%%hdudr®. .ekSug lghq;= flfr®'

ngha;ahd Neu#rpia toq;Ftijj; jtpu;j;Jf; nfhs;SkhW fLikahf mwpTWj;jy; toq;FfpNwd;. mt;thW ngha;ahd Neu#rp toq;Fk;

Mrpupau;fSf;Fk; epWtdj; jiytu;fSf;Fk; vjpuhf xOf;fhw;W eltbf;if vLg;gjw;F Vw;ghLfs; nra;ag;gl;Ls;sd.

You are throughly advised not to submit incorrect time tables. Disciplinary action will be taken against the teachers and Heads of institutions who submit false time tables.

(d) mdi, mokï lr.;a we.hSï jevms<sfj< hgf;a wod< úIhh fjkqfjka 13 fY%%a◊Kshg Tn úiska ls%%hd;aul lrk ,o we.hSï ixLHdj$Fwpg;gpl;l ghlk; njhlu;ghf ghlrhiykl;lf; fzpg;gPl;L Ntiyj;jpl;lj;jpd; fPo; 13 Mk; juj;jpy; jq;fshy; nraw;gLj;jg;gl;l fzpg;gPLfspd;

vz;zpf;if$ No. of Assessments conducted by you for Grade 13 under the SBA program for the relevant subject: 13 fY%aKsh m<uq jdrfha$ 13Mk; juj;jpd; Kjyhk;; jtiz$In Term I of Grade 13

13 fY%aKsh fojk jdrfha$ 13Mk; juj;jpd; ,uz;lhk; jtiz $In Term II of Grade 13

fuu we.hSï ie,iqï l=uk we.hSï m%%fNao wkqj ilia lf<a ±hs olajkak' ,f; fzpg;gPl;Lj; jpl;lq;fs; vj;jifa fzpg;gPl;L tif vd;gij ,q;F Fwpg;gpLf.

State the Assessment modalities used for those assessments:

'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

by; olajd we;s fm!oa.,sl ld, igyk" mdif,a wkqu; ld, igyk wkqj o mdi, mokï lr.;a we.hSï ms<sn`o f;dr;=re" m%%.;s igyka wkqj o m%%;sM, ms<sn`o f;dr;=re" m%;sM, f,aLkh wkqj o ksjerÈ njg iy;sl lrñ' NkNy jug;gl;Ls;s jdpg;gl;l Neu#rp ghl rhiyapd; mDkjpf;fg;gl;l Neu#rpf;fpzq;f rupahdnjdTk;> ghlrhiy kl;lf; fzpg;gPl;L tpguq;fs; Kd;Ndw;wf;

Nfhitapy; cs;sgb rupahdnjdTk; ngWNgWfs; njhlu;ghd jfty;fs; ngWNgw;Wg; gl;baypd;gb rupahdnjdTk; cWjp nra;fpd;Nwd;. I hereby certify that the personal time table given above is correct according to the approved timetable of the school, details of SBA is correct according to progress reports and the statistics of results are correct according to the results sheet.

ksfhdacH úÿy,am;sf.a ku gpujp mjpgupd; ngau; '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' Name of the Deputy Principal w;aik yd Èkh ifnahg;gKk; jpfjpAk; ''''''''''''''''''''''''''''''''''''''''''' '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' Signature & Date ^ks, uqødj$gjtp Kj;jpiu$ Official frank&

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04

(ii) .=re WmfoaYljreka i`oyd$Mrpupa MNyhrfu;fSf;F$For In-Service Advisors (a) .=re WmfoaYl f,i m;a jQQ Èkh Mrpupau; MNyhrfuhf epakdk; ngw;w jpfjp

Date of appointment as an ISA (b) úIhh$úIh fCIa;%%h ghlk; $ghlg;Gyk; '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' Subject/ subject field ^Wiia fm<$idudkH fm<$m%%d:ñl wd§ jYfhka&$f.ngh.j( c.juk; )$rh.juk; )$Muk;gg;gpupT Mfpa )

(eg. G.C.E. (AL)/ (OL)/ Primary etc.)

(c) fiajh lrk l,dmh$Nritahw;Wk; tyak;$Zone serving ( '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

fldÜGdih$Nfhl;lk;$ Division ( '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

(d) fuu úIhhg wod<j Tfí idudkH rdcldß lghq;=$,g;ghlk; njhlu;ghf jq;fsJ cj;jpNahff; flikfisr; RUf;fkhff;

Fwpg;gpLf. $Your normal duties related to this subject ( ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

Y YY Y M M D D}}

(iii) wOHdmk fCIa;%%fha fiajfha fh§ isák fjk;a ks,OdÍka i|yd$fy;tpg; Gyj;jpy; gzpahw;Wk; Vida mYtyu;fSf;F $ For other officers working in the field of Education (a) wod< úIh fCIa;%%h iy thg m;ajQQ Èkh$cupa ghlg;GyKk; epakdj; jpfjpAk;$Relevant subject field and the date of appointment to it ( ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

(b) ,l=Kq lsÍug b,a¨ï lrk úIhh yd iïnkaOj w'fmd'i' ^W'fm<& úIh ks¾foaYhg wod<j ±kg Tn bgqlrk ld¾hhka ms<sn| úia;r fuys i|yka lrkak'$ Gs;spapl tpz;zg;gpj;Js;s ghlk; njhlu;gpy; f.ngh.j.(c.ju) ghlj;jpl;lj;jpw;fika

jw;NghJ jq;fshy; Mw;wg;gLk; fy;tpg;gzpfs; gw;wpa tpguq;fs;$ Mention the duties you are engaged in, in relation to the subject applied for marking and in connection with the G.C.E. (A/L) syllabus ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

by; i|yka f;dr;=re i;H njg iy;sl lrñ'$Nkw;gb tpguq;fs; ahTk; rupnad cWjpg;gLj;Jfpd;Nwd;.$I hereby certify that the above mentioned information is true.

Èkh$jpfjp$Date ( '''''''''''''''''''''''''''''''''' ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

l,dm wOHdmk wOHCI$fldÜGdi wOHdmk wOHCI$wdh;k m%%Odkshdf.a w;aik tyaf; fy;tpg;gzpg;ghsu;$Nfhl;lf; fy;tpg;gzpg;ghsu;$ epWtdj; jiytupd; xg;gk; Signature of Zonal/ Divisional Director of Education/ Head of Institution ^ks, uqødj wksjd¾h fõ'& ( gjtp Kj;jpiu fl;lhak; )

(Official Frank is compulsory.)

(c) ,l=Kq lsÍug b,a¨ï lrk úIhh i`oyd mdif,a w'fmd'i' ^W'fm<& 2017 úNd.fha § ,enQQ m%%;sM, (

Gs;spapl tpz;zg;gpj;Js;s ghlj;jpy; f.ngh.j.(c.ju)g; guPl;ir 2017 ,y; khztu;fspd; ngWNgW.

Results obtained by the school at the G.C.E. (A/L) - 2017 Examination for the subject applied for marking :

fmkS isá ixLHdj$Njhw;wpNahu; njhif$No. sat (

iu;a ixLHdj$rpj;jpaile;Njhu; njhif$No. passed (

iu;a m%%;sY;h$rpj;jpapd; tPjk;$ Pass percentage (

mdif,a iuia; m%%;sM,hghlrhiyapd; ngWNgW

Overall result of the school

Tn b.ekajQQ isiqkaf.a m%%;sM, ePq;fs; fw;gpj;j khztu;fspd; ngWNgW

Results of the students you taught

05

13' we.hSï lghq;= iïnkaOfhka we;s m<mqreoao$kjpg;gPl;Lf; flikfspy; ePq;fs; ngw;Ws;s mDgtk;$Experience in evaluation

(i) w'fmd'i' ^W'fm<& úNd.fha$f.ngh.j (c.ju)g; guPl;irapy;$G.C.E. (A/L) Examination

(a) b,a¨ï lrk úIhfha iyldr mÍCIljrhl= jYfhka m<mqreoao wjqreÿ

tpz;zg;gpf;Fk; ghlj;jpy; cjtpg; guPl;rfuhf mDgtk; tUlq;fs;

Experience as an Assistant Examiner of the subject applied ≥ Years

(b) b,a¨ï lrk úIhh wjika jrg we.hSï l< j¾Ih ixfla; wxlh

tpz;zg;gpf;Fk; ghlj;jpy; ,Wjpahfg; gzpahw;wpa tUlk; FwpaPl;L vz;

Last year in which you marked the applied subject Code No.

(c) b,a¨ï lrk úIhh yer fjk;a úIhhl iyldr mÍCIljrhl= f,i m<mqreoao wjqreÿ

tpz;zg;gpf;Fk; ghlk; jtpu NtW ghlq;fspy; cjtpg; guPl;rfuhf mDgtk;: tUlq;fs;

Experience as an Assistant Examiner of a subject other than the subject applied Years

(a) by; (c) g wod< úIhh wjika jrg we.hSï l< j¾Ih

NkNy (c) Fwpg;gpl;l ghlk; ,Wjpahf Gs;spapl;l tUlk;

Subject relevant to (c) above Last year participated in marking

(ii) (a) w'fmd'i' ^W'fm<& úNd.fha b,a¨ï lrk úIhh i|yd w;sf¾l m%%Odk mÍCIljrhl= jYfhka m<mqreoao( wjq

f.ngh.j.(c.ju)g; guPl;irapy; tpz;zg;gpf;Fk; ghlj;jpy; Nkyjpf gpujk guPl;rfuhf mDgtk; tUlq;fs;

Experience as an Additional Chief Examiner for the G.C.E. (A/L) Examination for the subject applied : Year

(b) wjika jrg tu ;k;=r ±rE j¾Ih ixfla; wxlh

,Wjpahf mg; gjtpapy; flikahw;wpa tUlk; FwpaPl;L vz;

Last year in which the above post was held Code No.

(c) fuu j¾Ifha w;sf¾l m%%Odk mÍCIl ;k;=rla ,enqKfyd;a th Ndr .ekSug leu;s o@ Tõ ke;

,t;tUlk; Nkyjpf gpujk guPl;rfuhf epakpf;fg;gbd; mij Vw;Wf; nfhs;tPuh? Mk; ,y;iy

Would you like to accept an appointment as an Additional Chief Examiner this year ? Yes No

(iii) miq.sh jif¾§ Tng w;sf¾l m%%Odk mÍCIljrhl=$ iyldr mÍCIljrhl= f,i ;k;=rla ,en hï f,ilska tu

;k;=frys lghq;= fkdlf<a kï thg fya;= olajkak

fle;j tUlk; Nkyjpf gpujk$ cjtp guPl;rfuhf epakpf;fg;gl;bUe;Jk; jhq;fs; mf;flikia Vw;fhJ tpl;bUg;gpd; mjw;fhd fhuzk;

Indicate the reasons If you were appointed as an Additional Chief/ Assistant Examiner last year and could not attend duties.

'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

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(iv) l,ska we.hSï lr miq.sh jir lsysmhl § we.hSï i`oyd iyNd.s fkdjQQfha kï thg fya;= olajkak'

Kd;du; kjpg;gPl;L flikfspy; <Lgl;bUe;J> mjd;gpd; kjpg;gPl;Lf; flikfspy; <LglhjpUg;gpd; mjw;fhd fhuzk;

Indicate the reasons If you have participated in evaluation some time back but did not participate in it during recent years.

'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

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17' iy;sl lrk ks,Odßhdf.a ks¾foaYh cWjpg;gLj;Jk; mYtyupd; tpjg;Giu

Confidential Report of the certifying officer : (Please read the instructions given in the last page, before completing) (i) by; i|yka úNd.fha W;a;rm;%% we.hSu i|yd fuu whÿïlre f;dard .ekSu iïnkaOfhka Tnf.a ks¾foaYh meyeÈ,sj igyka lrkak'$Nkw;gb guPl;irapd; tpilj;jhs; kjpg;gPl;Lg; gzpf;F ,t;tpz;zg;gjhupiaj; njupT nra;tJ njhlu;ghf jq;fsJ

tpjg;Giuiaj; njspthff; Fwpg;gplTk;.$State your recommendation clearly regarding the selection of this applicant for evaluation of answer scripts at of the above examination. fuu whÿïlre yd iïnkaO j Tyqf.a$wehf.a$rhd;Wg;gLj;Jk; mYtyupd; me;juq;f mwpf;if$Regarding this applicant, his/ her (a) ,l=Kq lsÍug b,aÆï lrk úIh ms<sn| ksmqK;dj (c) b.ekaùfï$ rdcldÍ lghq;= ms<sn| lemùu Gs;spapl tpz;zg;gpf;Fk; ghlj;jpYs;s epGzj;Jtk; fw;gpj;jy; flikfspy; cs;s mu;g;gzpg;G

Competency in the subject, applied for marking Dedication to work/ duties

(b) j.lSï ±Ífï yelshdj (d) kdhl;ajh yd lKavdhula fufyhùfï we;s yelshdj nghWg;Ngw;Fk; jd;ik jiyikj;JtKk; FOnthd;iw ,af;Fk; Mw;wYk;

Ability to bear responsibilities Leadership and ability to lead a group

'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

(ii) by; wxl 01 isg 12 olajd iy 15 fþofha we;s lreKq ksjerÈ nj fuhska iy;sl lrñ' fuu whÿïlre W;a;rm;%% we.hSï lghq;= i|yd iqÿiq nj;a" tu lghq;= i|yd f;dard.;fyd;a ksoyia lsÍug tl`. jk nj;a okajd isáñ' NkNy 01 njhlf;fk; 12 tiuahd tpguq;fSk; 15 ,Ys;s tplaq;fSk; rupnad cWjpg;gLj;Jfpd;Nwd;. mj;Jld; Fwpj;j kjpg;gPl;Lf;flikf;fhf

tpz;zg;gjhupia tpLtpf;fr; rk;kjpf;fpd;Nwd;.

I hereby certify that the information contained in sections 01 to 12 and in section 15 is correct and this applicant is suitable to serve as a marking examiner and I agree to release him/her if selected. úÿy,am;sf.a$wdh;k m%%Odkshdf.a mjpgupd; / epWtdj; jiytupd;

Principal/ Head of Institution ku$ngau;$ Name ( '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

w;aik$ifnahg;gk;$Signature ,smskh$Kftup$ Address ( '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' Èkh$jpfjp$ Date ( ''''''''''''''''''''''''''''''''''''''''''''''''' ^ks, uqødj wksjd¾h fõ'& ( gjtp Kj;jpiuiaf; fl;lhak; ,lTk; )

(Official Frank is compulsory.)

^iïmQQ¾K lsÍug fmr 07jk msgqfõ we;s Wmfoia lshjkak'&(g+uzg;gLj;Jtjw;F Kd; 07 Mk; 08Mk; gf;fj;jpYs;s mwpTWj;jy;fisAk; thrpf;fTk;.)

(Please read instructions on page 08 before completing the application)

06

16' whÿïlref.a m%%ldYh$tpz;zg;gjhupapd; $w;W$Declaration of applicant by; i|yka f;dr;=re i;H yd ksjerÈ nj;a" ud ±kg úNd. lghq;= ;ykï lrkq ,enQQjl= fkdjk nj;a" m%%ldY lrk w;r fuu b,a¨ïm;%%fha idjoH f;dr;=re imhd úNd. fomd¾;fïka;=j fkdu`. heùula l< njg fy<s jqjfyd;a úkhdkql+, ls%%hd ud¾.hlg hg;a ùug isÿjk nj;a uu oksñ' W;a;rm;%% mÍCIljrhl= jYfhkAa f;dard .;fyd;a" m;a lrkq ,nk we.hSï uOHia:dkh msysá wdh;kfha f.!rjh wdrCId jk f,i yd wdh;kfha kS;ssÍ;sj,g wjk;j lghq;= lsÍug;a" úNd. mkf;a úêúOdk yd úNd. flduidßia ckrd,a úiska fokq ,nk Wmfoia yd we.hSï ld¾h uKav,h úiska ms<smeÈh hq;= wdpdrO¾u ms<sme§ug;a tl`. fjñ'

Nkw;$wg;gl;l tpguq;fs; ahTk; cz;ikahditnad;Wk; gpioaw;witnad;Wk; ehd; jw;NghJ guPl;ir eltbf;iffspypUe;J jilnra;ag;gl;bUf;f

tpy;iy vd;Wk; cWjpg;gLj;JtJld; ,t;tpz;zg;gg;gbtj;jpy; ngha;ahd jfty;fis toq;Ftjd; %yk; guPl;irj;jpizf;fsj;ij jtwhd topapy;

,l;Lr; nrd;wjhfj; njupatupd; xOf;fhw;W eltbf;iffSf;F cl;gLj;jg;gLNtd; vd;gijAk; ehd; mwpNtd;. tpilj;jhs; guPl;rfuhf njupT nra;ag;gbd;

epakpf;fg;gLk; kjpg;gPl;L epiyak; mike;Js;s epWtdj;jpd; nfsutj;ijg; NgZk; tifapYk; guPl;irr;rl;lj;jpd; tpjpfSf;Fk; guPl;ir Mizahsu;

ehafj;jpdhy; toq;fg;gLk; mwpTWj;jy;fSf;Fk; ,zq;fp elg;Ngd; vdTk; cWjp $Wfpd;Nwd;. kjpg;gPl;Lf; FOtpDs; xOfNtz;ba xOf;f tpjp

fSf;Nfw;g elf;fTk; cld;gLfpd;Nwd;.

I hereby declare that the information given above is true and accurate and that I am not debarred from marking at present and I am aware that I will be subjected to disciplinary action if found to have submitted false information and mislead the department. If I am selected as a marking examiner, I agree to safeguard the dignity of the institution where the marking center is established and abide by its rules and regulations, 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 evaluation staff.

Èkh$jpfjp$Date ( ''''''''''''''''''''''''''''''''''' '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' whÿïlref.a w;aik$tpz;zg;gjhupapd; ifnahg;gk;$Signature of Applicant

14' Tn fyda Tfí mjqf,a idudðlhl= fyda fkajdislhl= fyda fuu úNd.hg fmkS isàug kshñ; o@ Tõ ke;

jq;fsJ gps;isNah> FLk;g cWg;gpdNuh tPl;bYs;s xUtNuh ,g;guPl;irf;Fj; Njhw;wTs;sduh? Mk; ,y;iy

Are you, a family member or a resident of your house expect to sit this examination this year? Yes No ^07 msgqfõ 1'5 fþoh n,kak'$ 07 Mk;; gf;fk; 1.5 Ig; ghu;f;f $See Paragraph 1.5 on page 08.

fmkS isà kï ta l=uk Èia;s%%lalfhka o@$Njhw;Wgtuhapd; Njhw;Wk; khtl;lk; $If yes, from which district is it ? l=uk úIhka o@$Njhw;Wk; ghlq;fs;$ What are the subjects?

15' (i) ±kg Tng úreoaOj úkhdkql+, mÍCIKhla meje;afjkafka o@ Tõ ke; jw;NghJ jq;fSf;F vjpuhf xOf;fhw;W eltbf;iffs; VJk; eilngWfpd;wdth? Mk; ,y;iy

Is any disciplinary inquiry against you in progress? Yes No

(ii) Tn úNd. ;ykï lrkq ,enQQfjla o@ Tõ ke; ePq;fs; guPl;irf; flikfspy; jilf;Fl;gl;ltuh? Mk; ,y;iy

Are you debarred from examination duties ? Yes No

(iii) tfia kï ta ms<sn| úia;r olajkak'$Mk; vdpd; mJ gw;wpa tpguq;fisf; Fwpg;gpLf $If yes, give details ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

^wod< fldgqj, ^√& ,l=K fhdokak'& ^fuu fldgq iïmQ¾K lr fkdue;s b,a¨ïm;%% m%%;sfCIam lrkq ,efí'&( Fwpj;j $l;by; √ milahskpLf. ) ( fl;lq;fs; epug;gg;glhjtplj;J tpz;zg;gk; epuhfupf;fg;gLk; )

Tick ( Ã ) the relevant box. (If these boxes are not filled the application will be rejected.)

''''''''''''''''''''''''''''''''''''''''''''''''

tpz;zg;gg;gbtj;ij g+uzg;gLj;Jtjw;fhd mwpTWj;jy;fs; :

1.1 2011.03.01k; jpfjpaplg;gl;L jpUj;jpaikf;fg;gl;l 03(01) 2009k; ,yf;f Rw;WepUgj;jpd; mwpTWj;jy;fisg; gpd;gw;wTk;.

1.2 fPNo Fwpg;gplg;gl;Ls;s jifikfisg; ngw;W jw;NghJ fy;tp mikr;rpd; fPOs;s epWtdq;fspy; flikGupAk; Mrpupau;fSk;> fy;tpg;gzpfspy; <Lgl;bUg;gtu;fSk; ,jw;F tpz;zg;gpf;f KbAk;. (m) tpz;zg;gpf;Fk; ghlj;jpy; gl;ljhupahf ,Uj;jy; my;yJ bg;Nshkh rhd;wpjo; ngw;wpUj;jYld; cupaKiwapy; epue;ju epakdk; ngw;wpUj;jy;.

(M) ghlrhiyapy; Nritahw;Wtjhapd; f.ngh.j.(cau; ju) tFg;Gfspy; (12> 13) tpz;zg;gpf;Fk; ghlj;ij fw;gpj;jy;> Vida cj;jpNahfj;ju;fshapd; jw;NghJs;s f.ngh.j.( cau; ju ) ghlj;jpl;lk; rk;ge;jkhd fy;tp MNyhridg; gzpfspy; <Lgly;.1.3 ,y 11 Ig; g+uzg;gLj;Jk;NghJ tpz;zg;gpf;Fk; ghlj;Jf;Fg; nghUj;jkhf ePq;fs; ngw;Ws;s jifikfisf; fl;lhakhff; Fwpg;gply; Ntz;Lk;. ghlq;fs; Fwpf;fg;glhj gbtq;fs; epuhfupf;fg;gLk; vd;gijf; fUj;jpy; nfhs;sTk;.

1.4 tpz;zg;gg;gbtj;jpd; 14 Mk; 15Mk; ge;jpfisg; g+uzg;gLj;Jk;NghJ ‘Mk;’ my;yJ ‘,y;iy’ vd ‘ Ã ’ milahsj;ij njspthff; Fwpg;gplTk;. Fwpf;fhjtplj;J tpz;zg;gk; epuhfupf;fg;gLk;. * jw;NghJ jq;fSf;F vjpuhf xOf;fhw;W eltbf;iffs; vJTk; eilngWkhapd; my;yJ jhq;fs; guPl;ir flikfspy; ,Ue;J jilnra;ag;gl;bUg;gpd; ,g;gjtpf;fhd tpz;zg;gj;jpid rku;g;gpf;f KbahJ.

1.5 FLk;g cWg;gpdu; vdg;gLNthu; - jhq;fs;> jq;fsJ Jiztu;> Jiztpau;> gps;isfs;> jq;fspdJk; JiztupdJk; rNfhju rNfhjupfSk;

mtu;fsJ gps;isfSk; Mtu;.

1.6 xU tpz;zg;gjhup VNjDk; xU ghlj;jpw;F kl;LNk tpz;zg;gpf;fyhk;.

1.7 Nkw;gb guPl;irapd; kjpg;gPl;L epiyaq;fs; fPo;tUk; efuq;fspy; epWTtjw;F cj;Njrpf;fg;gl;Ls;sJ.

01 nfhOk;G 25 fhyp 37 jpUNfhzkiy 53 aho;g;ghzk; 10 fSj;Jiw 27 khj;jiw 38 Nffhiy 13 fk;g`h 30 FUehfy; 41 fz;b 15 ,uj;jpdGup 32 Fspahg;gpl;b 50 kl;lf;fsg;G

20 gJis 35 mEuhjGuk; 51 tTdpah

Fwpg;G : NghjpasT tpz;zg;gq;fs; fpilf;fg;ngwhj efuq;fspy; kjpg;gPl;L epiyaq;fs; epWtg;glkhl;lhJ. vdNt

ePq;fs; tpUk;gpd; ,uz;lhtJ njupitAk; Fwpg;gpLf.

07

1'7 mQQ¾fjdala; úNd.fha W;a;rm;%% we.hSï uOHia:dk msysgqùug fhdað; k.r f,aLkh my; olafõ' ^we.hSï ld,h Èk 14 la muK fõ'&

ie'hq' m%%udKj;a b,a¨ïm;%% ixLHdjla fkd,efnk k.rj, we.hSï uOHia:dk msysgqjkq fkd,efí' tneúka fojk leue;Aa; o b,a¨ïm;%%fhA i|yka l< hq;= h'

1'8 m;aùu fokq ,nkafka fm!oa.,sl fyda rdcldß ,smskhg wdikak u we.hSï uOHia:dkhg h' tu uOHia:dkfha wod< úIhfha we.hSï uKav, fkdue;s kï fydA m%%udKj;a mqrmamdvq ixLHdjla fkd;sfí kï fyda fjk;a wdikak we.hSï uOHia:dkhlg fhduq flf¾'

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01. Instructions to complete the application: 1.1 Instructions of Circular No. 03 (01) 2009 dated 01.03.2011 should be followed.

1.2 Teachers and officers presently working under the Ministry of Education who fulfill the following requirements can apply. (a) Having studied the subject applied for the Degree/ Diploma and possess a proper appointment as a gradute teacher.

(b) Teaching the subject applied for at the G.C.E. (A/L) (Grade 12, 13) classes as a teacher or engaged in duties related to G.C.E. (A/L) syllabus as an officer.

1.3 When filling Section 11, it is compulsory to include qualifications relevant to the subject. Failure to state subjects will result in rejection of the application.

1.4 When filling Section No.14 & 15, clearly indicate 'Yes' or 'No' with a ' Ã ' in the relevant box. If this section is not completed properly your application will be rejected. * If there's a disciplinary inquiry in progress against you or you are debarred from marking, you cannot submit an application form.

1.5 A family member means your spouse, children or siblings of you or your spouse and their children. 1.6 An applicant can apply for one subject only. 1.7 It is expected to establish Evaluation Centers in the following towns: (Evaluation period will be about 14 days.)

N.B. Evaluation Centers will not be established in towns where a sufficient number of applications are not received. Therefore, your second choice also should be mentioned. 1.8 The appointment will be given to the town closest to the private or official address. If there are no evaluation panels of the subject applied in the closest center or if there are no vacancies, you will be directed to another nearest evaluation center.

1.9 Fill this form (except Section 17) and handover it to the Principal / Head of your institution.

02. Certifying officer: Certification should be done by the Principal for a teacher, by the Zonal Director of Education for an In-Service Advisor attached to Zone, by the Divisional Director of Education for an In-service Advisor attached to a Divisional Education office and Head of Institution for an Education Zone any other officer.03. Instructions to certifying officer: 3.1 Examine whether the information provided by the applicant is correct. 3.2 Certification of information stated in the relevant place on page 06 is compulsory. 3.3 State your assessment of the applicant related to the details from 17 (i) (a) to (d) above by indicating the relevant letter in the cage. A - Excellent B - Good C - Satisfactory W - Weak N.B. - W is considered as an ineligibility to get an appointment as a marking examiner.

3.4 This is a confidential report. Keep copies of the duly completed application forms after certification and send them along with a schedule to reach the following address before April 30, 2018. Indicate "Application for Marking Examiners - AL 2018" top at the left corner of the envelope.

01. Colombo 10. Kalutara 13. Gampaha 15. Ratnapura 20. Badulla 25. Galle

27. Matara 30. Kurunegala 32. Kuliyapitiya35. Anuradhapura37. Trincomalee 38. Kegalle

41. Kandy50. Batticaloa51. Vavuniya53. Jaffna

Commissioner General of ExaminationsEvaluation (School Exams) Branch

Department of Examinations, Sri LankaP. O.Box. 1503

ColomboThis application form is published at the department website as well. (www.doenets.lk)

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