Online Application | VHC Institute of Allied Health Sciences

1

Course Applied For

Select the programme and LMS study medium.

Caregiver NVQ 3 Professional caregiving pathway Nurse Assistant NVQ 4 Allied health care training Care Taker Certificate Short professional programme

Level

Medium *

Tamil Sinhala English

2

Applicant Information

Enter details exactly as they appear in official documents.

NIC Number *

Date of Birth *

Age

Gender / Sex *

Applicant's Name with Initials *

First / Calling Name

Name in Full - English Block Letters *

Permanent Address - English Block Letters *

3

Residence & Contact Details

These details help the institute contact the applicant quickly.

Province

District

Grama Niladhari Division

Home Telephone

Mobile Number *

WhatsApp Number

Email Address *

4

Educational Qualifications

Fill the applicable sections. Leave non-applicable rows empty.

Highest Academic Qualification *

G.C.E. O/L Year

G.C.E. O/L Results

5 rows

SN	Subject	Grade	Index No	Year of Exam
01
02
03
04
05

G.C.E. A/L Year

G.C.E. A/L Results

4 rows

SN	Subject	Grade	Index No	Year of Exam
01
02
03
04

Vocational Qualification

3 rows

SN	Name of Vocational Qualification	NVQ Level	Institution Name
01
02
03

If required qualifications are not fulfilled

Complete this part only when applicable.

Highest Grade Passed

Year

School Name

5

Documents & Payment Proof

Accepted formats: PDF, JPG, JPEG, PNG.

Passport Size Photo *

JPG or PNG, maximum 2 MB

Academic Documents *

O/L, A/L or qualification certificates

NIC Copy *

Clear front/back copy

Bank Payment Receipt *

Attach payment slip/receipt

Bank Account Details

Account Name: Vavuniya Health care (Pvt) Ltd

Account No: 0055 1000 3863

Bank: Sampath Bank

Branch: Vavuniya

6

Applicant Declaration

Read carefully before submitting.

I hereby declare that the information provided in this application is accurate and complete to the best of my knowledge. I understand that providing any false or misleading information may lead to the rejection of my application or dismissal from the programme.

Applicant Signature Name

Date

I confirm that the above information and uploaded documents are true and correct. *