application

Registered Charity Organization in UK Charity No: 1119445 www.malayaham.net email:malayagam@yahoo.com MALAYAGA MAKKAL ONDRIYUM (MMO-UK) 28, Highams Hill Gosspsgreen, Crawley, RH1 1 8BS. TP 01293530964/07723043000 Please complete all the fields in full if any field not filled your application will be delay in processing * This means please provide a photocopy of the original documents Application only considered if both or one parent work in Tea Plantation தய# ச&' எ)ல வ-ற ட1க ள56 78 மய க ந ர<ப#6 Please fill Name address in English only. Completed application must be email to malayagam@yahoo.com 1. Personal information ச >த? தகவ)க@ Applicant s full name வABண<பத DயAE 78< பயF Gender ப ) *Date of Birth / Identity Card No பAற>த தத *Current address 7கவD Email Address & Telephone No City and District நகர6 & ம வHட6 Current School/University name/address

*தF ப தய ப டச ல அ)ல' ப)க லகழக6 / வAல ச6 *Start date of the Course end date of the Course *Title of the Course 2. HOUSEHOLD INFORMATION KL6ப? தகவ)க@ Father s full name த>த தயAE 78< பயF * Occupation & Address and income த ழ ) & வMம ன6 & வAல ச6 Mother s full name த யAE 78< பயF *Occupation & Address and income த ழ ) & வMம ன6 & வAல ச6 Number of siblings (mention order of birth) ம-ற பA@ ளகளOE எBணAP க Any other source of income பAற Qல1களO) இS>' வS6 வSம ன6 Briefly explain the reason, requesting scholarship from MMO உதவA? த க க SவதFக ன க ரன? த USPகம க Vற#6

As a MMO scholar, we expect every student who is receiving the scholarship must give back something to the community or society in return for the scholarship they have received. Can you please briefly explain how you are intending to do. ம லயக மPக@ ஒEற ய?த E Xல மபDச ) ம ணவ ர Sவர க ஒY வ S ம ணவS6 ஒBற ய?த -K6 ச7த ய?த -K6 பறபHட Xல மபDச ZPக க த S<பA? தSத ல6 ச&ய? த Hடம HL@ள [Fக@ என வAவD51க@. ந 6 எத Fப FPக ற 6. இத ன ந[1க@ எYவ M *Examination Results ப\H ச< பM பMக@ GCE Ordinary Level Exam Score or Latest Term Test Score ச த ரன தர< ப\H ச X@ளOக@ அ)ல' இMத? தவ ன ப\H ச X@ளOக@ (அற P க அH ட / பM பMகளOE பAரத ய E ற சமF<பAPக#6) (submit a copy of Report Card/Results with attestation) SUBJECT SCORE SUBJECT SCORE ப ட6 X@ளO/தர6 ப ட6 X@ளO/தர6 1. 7. 2. 8. 3. 9. 4. 10. 5. 11. 6. 12. *GCE Advanced Level Exam Score or Latest Term Test Score (submit a copy of Report Card/Results with attestation) உயF தர< ப\H ச X@ளOக@ அ)ல' இMத? தவ ன ப\H சX@ளOக@ (அற P க அH ட/ பM பMகளOE பAரத ய E ற சமF<பAPக#6)

SUBJECT SCORE ப ட6 X@ளO/தர6 1. 2. 3. Honors, Sports and other extracurricular activities களரவ1க@ வA ளய HLக@ ம-M6 இ னப ட சய-ப Lக@ Consent ச6மத6 By signing application, I hereby confirm that the information provided is complete and accurate to the best of my knowledge. I hereby provide my full consent to MMO U.K. to use, store, share, publish and promote information about myself, including my photograph, through any medium, including print, electronic and online, for program services and fund raising, I also here by agree to fully oblige and respect all the requirements and instructions given by the MMO and its Liaison Officer and to maintain the highest discipline during my academic career. I understand that this application doesn t guarantee a scholarship and MMO reserves the right to terminate the scholarship at any time. இYவABண<ப?த ) க]ச?த LவதE Qல6 என' ச ற>த அற வA- க-ப தர<பHL@ள தகவ)க@ 78 மய ன வ56 என ந E இ?த ) Qல6 உMத <பL?'க றE. வ ல?த Hட ச வக@, ந த சகD?த) ஆக ய ந Pகத -க க எE ன< ப-ற ய தகவ)க ள, என'X க<பட1க ள56 உ@ளடPக அ]U, இல?த ரE, இ ன?தல6 ஆக ய எ>த ஊடக?த E ஊட க#6 பயEபL'வத-K6 கள`ச ய<பL?'வத-K6 பக D>' க @வத-K6, பAரUDபத-K6 ஊPKவA<பத-K6 ந E இ?த ) ம லயக மPக@ ஒEற ய?த -K என' 78] ச6மத? த வழ1Kக றE. ம லயக மPக@ ஒBற ய?த ன Z6 அதE இ ன<பத க DயAன Z6 வழ1க<பL6 சகல த வகaPK6 அற #M?த)கaPK6 க ட ம<பL வE என#6 மத < பE என#6 என' க)வA க-ற) க ல?த b@ உயF ஒ8Pக? த< பc வE என#6 ந E இ?த ) இண1Kக றE. இYவABண<ப6 ஒS Xல மபDச ல உMத <பL?த ' எEப த56 எ>த க லகHட?த Z6 இ<Xல ம<பDச ல ர?' ச&56 உD ம ம லயக மPக@ ஒEற ய?த -K உBL எEப த56 ந E அற வE. Our bank in Sri-Lanka is people bank, therefore we recommend you to have a Peoples bank account. If not have please open in Peoples bank. Bank Name & Bank Addreess Bank Sort code: Bank Account No Account Name Please provide annually proof from the university the applicant following next year. The scholarship fund will be stopped if we did not receive this confirmation from your university. Applicant s Signature Date

வABண<பத ரDE க]ச?' த கத By signing below, I am the parent/legal guardian of the applicant and hereby provide my full consent to the above on behalf of the applicant and assume full responsibility for the applicant. க ழ கச?த LவதE Qல6 வABண<பத DயAE ப- ற F சHடeFவ ப 'க வலர க ய ந E வABண<பத DPக க 78< ப M< ப56 எ-க றE. Parent /Guardian Full name Date ப- ற F அ)ல' ப 'க வலDE 78< பயF த கத