First Degree

University of Moratuwa, Sri Lanka - General Convocation –2020

Supplication Form for First Degree

Name with Initial

01 THENUWARA H.V.
Eg. R.M.N. Rathnayaka
Last Name
02 THENUWARA
Eg. Rathnayaka
Names denoted by initials
03 Miss. HIRUSHI VANDANA
Eg. Rathnayake Mudiyanselage Nimal
You are requested to check your name
in 01,02 & 03 cages above. Please
04 mention your full name here only if
there is any spelling mistake/s or
difference

05 NIC No. / Passport No. 958343582V

06 Contact Address 16,Peragahaudumulla,Kithulawe,Kalutara South

07 Year of Entry 2015 Registration No. 150636C

Name of the First Degree in respect of

08 Honours Degree of Bachelor of the Science of Engineering
which the supplication is submitted.

09 Class Obtained Second Upper

10 Field of Specialization Civil Engineering

11
Dept. Department of Civil Engineering 11.(b) Faculty Faculty of Engineering
(a)

Year of passing the first Degree with Year Registration No.

12
Registration No. 2020 150636C
Residence Mobile Office
13 Tel. No
034 22 35411 0719542951 -

14 E-mail hirushivt@gmail.com

State whether the Degree is to be awarded “in person” or “in absentia”.(If you are
attending indicate as “in person” / if you are not attending indicate as “in absentia”.
15 In person
In the case of “in absentia” the degree will be conferred in the absence of the
graduand at the Convocation.)

I do solemnly declare that I will faithfully observe the Statutes, By-laws, Regulations and Rules of the University of
Moratuwa, Sri Lanka, so far as they may apply to me, and I will not make use of privileges that are to be conferred
upon me so as in any way to bring the institution to disrepute.

I certify that I have not been admitted to the above degree so far, and that the above facts are true and accurate to
the best of my knowledge.

2020-03-04
……………………… ……………………………………………
Date Signature of the Graduand

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First Degree

Notes for the graduands

Registration and Certificate Fee

Graduands are required to submit a pay-in-voucher for Rs. 2000/= obtained from any Bank of Ceylon Branch drawn in
favor of “University of Moratuwa” (Account Number 306836) along with the Supplication Form. Those who wish to
make this payment at the Shroff’s counter of this University may do so from 9.00 a.m. - 12.30 p.m. and 1.30 p.m. -
3.00 p.m. on working days up to 2020-04-30

Office Use Only

All cages must be essentially filled.

1. The name mentioned in cage 2 is correct / not correct (if not mentioned correct name)

……………………………………………………………………………………………

2. The details in cages 1,6,7,8,9 &10 are correct and the student is eligible for the conferment of the

Degree of ……………………………………………………………………………………………

Effective Date : ………………………

3. Senate approved the above results at its …………………………… Meeting held on ……………………………

Subject Clerk.: …………………………… Date ……………………………

DR/ Exams.: …………………………… Date ……………………………

Entered in the Graduands List.: …………………………… Date ……………………………

(Signature of Subject Clerk)

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