EXPRESSION OF INTEREST FOR FELLOWSHIP(FIB)/SENIOR FELLOWSHIP (FIB, senior) OF THE IBSL (Delete whichever inapplicable) 1.

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1 INSTITUTE OF BANKERS OF SRI LANKA.05, Mile Post Avenue, Colombo 03 Tel , / Fax Website : info@ibsl.lk, mr@ibsl.lk AFFIX PHOTO Passport size EXPRESSION OF INTEREST FOR FELLOWSHIP(FIB)/SENIOR FELLOWSHIP (FIB, senior) OF THE IBSL (Delete whichever inapplicable) 1. PERSONAL DATA 1.1 Name with Initials : (Mr. /Mrs. /Ms.) 1.2 Names Denoted by Initials : 1.3 Date of Birth : / / Age: Yrs NIC : 1.4 Correspondence Address : Contact Number Res : Mobile : 1.5.Current Designation : 1.6.Company Name & Address : Contact Number : address : 2. STATUS OF INSTITUTE MEMBERSHIPS 2.1.Associate Membership : AM 2.2.Year elected as an Associate Member : (As shown on your membership certificate) 2.3.Are you a Life - Associate Member? : 2.4 If, not, have you updated subscription up to the current year? : (Pl read Entry tes carefully before completing this application) Page 1 of 7

2 For Senior Fellowships only (if applicable) 2.5 Your Fellowship : FM 2.6 Year Elected as a Fellow Member (As shown on your membership certificate) 2.7 Are you a Life Fellow member? 2.8 If not, have you updated subscription up to the current year? Instructions to fill item 3,4,5,6 & 7 below: (a) If space is not enough, please submit as an annex paper. (b) Each item (3-7)should be supported by documentary evidence to earn marks. 3.OTHER PROFESSIONAL /ACADEMIC QUALIFICATIONS ACQUIRED Institution Qualification Year Completed 4.TRAINING AFTER ASSOCIATESHIP/FELLOWSHIP (4.1).Training programmes followed in Core banking areas: Period (4.2). Training programmes followed in n-core / Operational areas: (Please use the attached Training Report) 5. EMPLOYMENT EXPERIENCE AND MANAGERIAL POSITIONS HELD (5.1) Service Record after Associateship Institution Position Period Area (From - To) Core/Operational) (5.2) Service Record after Fellowship (For Senior Fellowship only) Institution Position Period Area (From - To) Core/Operational) Page 2 of 7

3 6. SPECIFIC CONTRIBUTIONS TO THE INDUSTRY (6.1)New Banking/Financial products introduced: (6.2) Management of overseas/local specialized projects: (6.3) Direct participation in formulation / review of Management and Financial policies: (6.4) Chairing / holding key positions in special / working committees/boards etc: (6.5) Any other contributions made for development of the industry/achievement of organizational goals. 7. YOUR CONTRIBUTION TO BANKING & FINANCE EDUCATION Contribution Institution Period (7.1) As a Lecturer: (7.2)As an Examiner: (7.3)As a Researcher: (7.4) As an Author of Study packs publications related to industry: Page 3 of 7

4 (7.5)Any other related contribution special claims: 8. APPLICANT S DECLARATION (Please read carefully) Having read the regulations of the Institute of Bankers of Sri Lanka, I of certify that the particulars furnished in this application are true and correct. I am aware that the Institute reserves the right to deny Fellowship Senior Fellowship without assigning reasons or withdraw Fellowship Senior Fellowship. If I am elected as a Fellow/Senior Fellow of the Institute, I hereby agree to uphold the highest professional standards and to dedicate myself to the furtherance of the Industry. I shall not use the title FIB/FIB senior,sri Lanka if the Governing Board decides to terminate the Fellowship /Senior Fellowship for other reasons. Date: : / / Signature: 9. PROPOSED FELLOWSHIP / SENIOR FELLOWSHIP CITATION (To be attached) (Pl give details in an Annexure not exceeding 200 words and the soft copy of the same to vs@ibsl.lk on or before the closing date) 10. CERTIFICATION A. SPONSOR S CERTIFICATION I recommend that Mr./Ms./Miss. is a fit and proper person for election as a FELLOW/SENIOR FELLOW of the Institute of Bankers of Sri Lanka. Proposed By (Fellow of the IBSL / Chief Executive Officer/Head of Human Resources): a) Name : b) Current Employment : c) Address : d) Qualifications : Contact : e) Year of election as a Fellow: f) Fellow Membership. Page 4 of 7

5 g) Reason for supporting the sponsorship : Date: : / / Signature & Seal Seconded By (Fellow of IBSL / Chief Executive Officer/Head of Human Resources): a) Name : b) Current Employment : c) Address : d) Qualifications : Contact : e) Year of election as a Fellow : f) Fellow Membership. g) Reason for supporting the sponsorship : Date: : / / Signature & Seal B. EMPLOYMENT CERTIFICATION (CHIEF EXECUTIVE OFFICER/ HEAD OF INSTITUTION /CHAIRMAN) This is to certify that Mr./Ms./Miss. has held managerial positions in this Institution as claimed in Column 5 of his/her application for a period of years and this applicant w.e.f. is holding the post of (Designation) The applicant is considered a fit and proper person to be elected as a Fellow/Senior Fellow of the Institute of Bankers of Sri Lanka. (date) I am aware of the claims made in para. 5 & 6 of this Application form. Name : Signature : Designation : Date : / / Name of Institution : Official Seal : Page 5 of 7

6 To : Institute of Bankers of Sri Lanka TRAINING ATTENDANCE CONFIRMATION REPORT This is to certify that Mr/Mrs/Miss.. attached to the (bank / institution) has attended at the following training programs. 1 Name of the Program / Seminars / Workshops Period Conducted by Branch Manager / Head of the Division / Training Manager / HR Manager (Official Seal ) Date Page 6 of 7

7 ENTRY NOTES 1. Eligibility to apply : Fellow Membership Associate Members (Life/Active) in the position of Executive level(agm/dgm) OR Associate Members with minimum 10 years post Associate member experience in Banks / Financial institutions/ n-financial institutions involving business operations connected with Banking & Finance are eligible to apply. Senior Fellow Membership Fellow Members (Life/Active) with minimum 5 years Fellow membership OR Associate Members with minimum 15 years post Associate member experience in Banks / Financial Institutions/n-Financial institutions involving business operations connected with banking & finance OR CEOs with AIB in banks/financial institutions / n-financial institutions. 2. Application & Evaluation Procedure : - Include the following with the application form Three passport size (3.5cmX4.5cm) color photographs duly attested by a Manager in a bank or Fin. institution /Attorney at Law/ Grama Niladari A service letter/s confirming work experience specifying core and operational areas of experience, current designation, copies of other professional and academic qualifications & training and other relevant documentary evidence to support claims Proposed Fellowship citation not exceeding 200 words Application processing fee of Rs. 500/- paid to a designated bank A/C given in the paying slip/ibsl Website. - Submit your application duly recommended by CEO/Head of institution/chairman - Assessment based on interview by the Governing Board. 3. Membership Fee : All selected candidates are required to pay following fees before award. Membership Category Membership Title Fees Annual Subscription Fees (Rs.) (Rs.) Fellow Member 50,000/- 3,000/- Senior Fellow Member * 15,000/- 3,500/- * The fee will be Rs. 70,000 for CEOs with AIB category and Rs.40,000 for Associate Category(with min. 15 yrs post Associate member experience). 4. Completed Applications : Duly completed EOI forms should be sent to: Director Member Relations Institute of Bankers of Sri Lanka.5, Mile Post Avenue Colombo-03. Enquiries : / / mr@ibsl.lk / vs@ibsl.lk Page 7 of 7