2025 REPEAT A/L INTAKE
Application Form
Note:
Please avoid submitting the application form multiple times after it has been successfully submitted.
Personal Information
Name With Initial
Gender
Male
Female
Date Of Birth
NIC
Address
Hometown
Choose your class type that you will follow:
Online Class
Physical Class
District
Ampara
Anuradhapura
Badulla
Batticaloa
Colombo
Galle
Gampaha
Hambantota
Jaffna
Kalutara
Kandy
Kegalle
Kilinochi
Kurunegala
Mannar
Matale
Matara
Monaragala
Mullaitivu
Nuwara Eliya
Polonnaruwa
Puttalam
Rathnapura
Trincomalee
Vavuniya
Past A/L Details
School/Institution
A/L Exam Index No
A/L Exam District Rank
A/L Z-Score
Contact Details
Student Contact No:
Student Email
A/L Stream
Biological Science
Physical Science
Attempt
1
2
Distance to LIYA Science College from your residence (in km)
Do you need hostel/boarding?
Yes
No
Medical Information
Have you previously studied at LIYA?
Yes
No
Enter your Student ID:
Parent / Guardian Details
Select a type
Parent
Guardian
Select a type
Parent
Guardian
Guardian 1
Parent/Guardian's Relationship
Parent/Guardian Name
Parent/Guardian's NIC
Address
Occupation
Monthly income (Rs.)
Parent/Guardian Contact No:
Parent/Guardian Whatsapp No:
Guardian 2
Parent/Guardian's Relationship
Parent/Guardian Name
Parent/Guardian's NIC
Address
Occupation
Monthly income (Rs.)
Parent/Guardian Contact No:
Parent/Guardian Whatsapp No:
Batch
Submit Form
