JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Student residence information for COVID 19 early preparedness response
Faculty of Management studies & Commerce, University of Jaffna, Sri Lanka
Sign in to Google
to save your progress.
Learn more
FULL NAME
Your answer
NAME WITH INITIAL
Your answer
NIC NUMBER
Your answer
PERMANENT ADDRESS
Your answer
UNIVERSITY REGISTRATION NUMBER
Your answer
YEAR OF STUDY
Choose
First Year
Second Year
Third Year
Fourth Year
CONTACT NUMBER (Mobile)
Your answer
CONTACT NUMBER (Land)
Your answer
CONTACT EMAIL
Your answer
If you are staying at your own residence during the ECE time, please fill the following details:
Permanent address:
Your answer
Name of your parent/guardian:
Your answer
Contact number of parent/guardian:
Your answer
DS Division:
Your answer
GS Division and No:
Your answer
Present Medical officer of Health (MOH) Area:
Your answer
Present Public health Inspector range:
Your answer
If you are staying at Hostel during the ECE time, please fill the following details:
Name of the Hostel:
Your answer
Room No:
Your answer
If you are staying at Private Boarding Place during the ECE time, please fill the following details:
Name of the Landlord:
Your answer
Contact No of landlord:
Your answer
DS Division:
Your answer
GS Division and No:
Your answer
Present Medical officer of Health (MOH) Area:
Your answer
Present Public health Inspector range:
Your answer
If you have any issues related to attending the course / sitting exams, please let us know
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of University of Jaffna.
Report Abuse
Forms
