1.1 Name with Initials : (Mr. /Mrs. /Ms.) 1.2 Names Denoted by Initials : 1.3 Date of Birth : / / Age : yrs NIC No: DD MM YYYY

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1 INSTITUTE OF BANKERS OF SRI LANKA Member Relations Division No.80A, Elvitigala Mawatha, Colombo 08 Tel /, Website : www. ibsl.lk mr@ibsl.lk AFFIX PHOTO Passport size EXPRESSION OF INTEREST FOR ASSOCIATE MEMBERSHIP OF THE IBSL (AIB, Sri Lanka) Instructions to Candidates: (a) DBF/DABF holders in the Managerial Level in a Bank /Financial Institution /Non bank Financial Institution /Any other business operation involving Banking & Finance OR DBF/DABF holders with minimum 4 years working experience in any of the above institutions are eligible to apply for the Associate Membership of the Institute. (b) Candidates should submit an Expression of Interest (EOI) providing an own assessment (Supported certified copies of documentary evidence) covering the areas given in this form along with the application processing fee of Rs. 500/- and three (03) passport size photographs. (c) The suitability of candidates will be through scrutiny of Expression of Interest and subject to the final approval of the Governing Board. (d) The selected candidates are required to pay Membership Title Fee of Rs. 25,000/- + Annual Membership subscription Fee of Rs. 2,000/- and arrears of subscription, if any. The Certificate for the Associate Membership will be awarded at the Annual Convocation. Application Closing Date : 10 th September PERSONAL DATA 1.1 Name with Initials (Mr. /Mrs. /Ms.) 1.2 Names Denoted by Initials 1.3 Date of Birth : / / Age : yrs NIC No: 1.4. Residence Address Contact Number : 1.5. No years in the service : 1.6. Current Designation 1.7.Company Name & Address District Telephone Number : Mobile No Preferred Mailing Address : Residence Office 2. INSTITUTE MEMBERSHIP DATA 2.1. Member Registration No : Page 1 of 5

2 2.2.Year completed Final Examination : DBF/DABF March/September 2.3.AM NO (For Office use Only) : 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. (c) I.Core Areas: The areas directly related to banking & finance functions such as Retail & Corporate Banking, International Trade Finance, Central Banking, Cash Management, Fund Management, Lending, Leasing, Hire Purchasing, Micro Finance, Development Finance, Bank Supervision etc. II.Non Core Areas/Operational Areas: Legal, HR, IT, Accounting, Logistic, Supplies, Premises, General Administration, Marketing, Research & Development, Training, Welfare, etc 3. OTHER PROFESSIONAL /ACADEMIC QUALIFICATIONS Institution Qualification year completed 4. TRAINING (4.1) Local Training : Programme Institution From -To (4.2) Foreign Training : (Please use the attached Training Report) Page 2 of 5

3 5. EMPLOYMENT POSITIONS HELD (SERVICE LETTER SHOULD BE ATTACHED) Institution Position Division/Dep/Br From -To No. of years 6. EMPLOYMENT EXPERIENCE IN (6.1) Core Areas of Banking or Finance : (6.2) Operational Areas : 7. SPECIFIC CONTRIBUTION TO THE BANKING & FINANCE INDUSTRY Contribution (7.1) Achievements in the Banking & Finance profession: Period (7.2) Contribution made for achievements of organizational goals: (7.3) Contribution made for introduction of New Banking /Financial products (7.4) Holding member positions in special / working committees etc: Page 3 of 5

4 (7.5) Any other contributions made for development of the Banking & Finance industry : 8. APPLICANT S DECLARATION 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 Associate Membership without assigning reasons or withdraw Associateship. 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 AIB, Sri Lanka if the Governing Board decides to terminate the Associate Membership for other reasons. Date : / / Signature : 9. EMPLOYMENT CERTIFICATION BY THE HEAD OF HUMAN RESOURCES / HEAD OF THE BRANCH This is to certify that Mr./Ms./Miss. is an employee of this Institution for a period of years and has held the position as claimed in 5 of this form. The applicant is considered a fit and proper person to be an Associate of the Institute of Bankers of Sri Lanka. Signature Name Designation Official Address Official Seal Date : / / Page 4 of 5

5 To : Director- Member Relations 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 5 of 5