This document contains an application for membership to the Sri Lanka Society for Medical Laboratory Science. It requests personal details like name, address, date of birth, and contact information. It also asks for professional details such as place of work, date of appointment, license number, and designation. Finally, it requests academic details including degrees, universities attended, and dates as well as any special trainings. The applicant agrees to abide by the rules and regulations of the Society.

1. 1. Personal Details
a. Full Name:.............................................................................................................................................
b. Name with initials:................................................................................................................................
c. Personal address:..................................................................................................................................
d. Date of Birth:...........................................
e. Contact details: Mobile:................................ E mail:............................................................................
2. Professional Details
a. Working place:......................................................................................................................................
b. Date of first appointment:............................................... c. SLMC Reg No.:……………………………………..
d. Official Address(present):.....................................................................................................................
e. Designation:..................................................................................... e. Tel No:....................................
3. Academic Details:
 Degree (If Applicable)
f. Name of the degree:.............................................................................................................................
g. University:.............................................................................................................................................
h. Effective date of the certificate:...........................................................................................................
i. Post graduate qualifications:.................................................................................................................
 Diploma Awarded (If Applicable)
j. MLT School:...........................................................................................................................................
k. Effective date of the certificate:...........................................................................................................
l. Special trainings:....................................................................................................................................
4. Other Relevant Details:
……………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………
..................................................................................................................................... I do agree the
rules and regulations of the constitution of the Sri Lanka Society for Medical Laboratory Science.
Date: Signature
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Approval Office use only
Membership is accepted
President – SLSMLS Secretory - SLSMLS
Sri Lanka Society for
Medical Laboratory Science
Po Box 41, Maharagama / +94 77 3077717 / Fax: 0112689254
Medicallaboratoryscience.sl@gmail.com /
Membership No:
Membership Application

2. slsmls.org/ E mail:medicallaboratoryscience.sl@gmail.com/slsmls8205@gmail.com