{"id":562,"date":"2023-11-08T12:26:11","date_gmt":"2023-11-08T12:26:11","guid":{"rendered":"https:\/\/csc.jfn.ac.lk\/expr\/?page_id=562"},"modified":"2026-09-02T07:52:15","modified_gmt":"2026-09-02T07:52:15","slug":"application","status":"publish","type":"page","link":"https:\/\/csc.jfn.ac.lk\/expr\/application\/","title":{"rendered":"Application Form | Batch IV | Phase I"},"content":{"rendered":"\n<div style=\"height:22px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(0, 0, 0, 0.8);}<\/style><form method='post' enctype='multipart\/form-data'  id='gform_4'  action='\/expr\/wp-json\/wp\/v2\/pages\/562' data-formid='4' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_4' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_4_48\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_48\" ><h3 class=\"gsection_title\">Applicant Information<\/h3><\/div><fieldset id=\"field_4_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_1\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name in Full (as per NIC)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_4_1'>\n                            \n                            <span id='input_4_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_4_1_3' class='gform-field-label gform-field-label--type-sub '>First name<\/label>\n                                                    <input type='text' name='input_1.3' id='input_4_1_3' value=''   aria-required='true'    autocomplete=\"given-name\" \/>\n                                                <\/span>\n                            \n                            <span id='input_4_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_4_1_6' class='gform-field-label gform-field-label--type-sub '>Last Name<\/label>\n                                                            <input type='text' name='input_1.6' id='input_4_1_6' value=''   aria-required='true'    autocomplete=\"family-name\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_4_41\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_41\" ><label class='gfield_label gform-field-label' for='input_4_41'>Title (Mr \/ Ms \/ Rev \/ Dr):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_4_41' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_39\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_39\" ><label class='gfield_label gform-field-label' for='input_4_39'>Name with Initials:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_39' id='input_4_39' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_36\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_36\" ><label class='gfield_label gform-field-label' for='input_4_36'>NIC Number:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_4_36' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_24\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_24\" ><label class='gfield_label gform-field-label' for='input_4_24'>Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_24' id='input_4_24' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_4_24_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_4_24_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_4_24' class='gform_hidden' value='https:\/\/csc.jfn.ac.lk\/expr\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_4_25\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_25\" ><label class='gfield_label gform-field-label' for='input_4_25'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_25' id='input_4_25' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Select' >Select<\/option><option value='Male' >Male<\/option><option value='Female' >Female<\/option><\/select><\/div><\/div><div id=\"field_4_10\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_10\" ><label class='gfield_label gform-field-label' for='input_4_10'>Contact Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_10' id='input_4_10' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"tel\" \/><\/div><\/div><div id=\"field_4_52\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_52\" ><label class='gfield_label gform-field-label' for='input_4_52'>Whatsapp Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_52' id='input_4_52' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_4_52\" autocomplete=\"tel\" \/><\/div><div class='gfield_description' id='gfield_description_4_52'>for future communications<\/div><\/div><fieldset id=\"field_4_2\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_2\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_4_2_container'>\n                                <span id='input_4_2_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_2' id='input_4_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"email\"\/>\n                                    <label for='input_4_2' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_4_2_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_2_2' id='input_4_2_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"email\"\/>\n                                    <label for='input_4_2_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_4_21\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_21\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Postal Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city ginput_container_address gform-grid-row' id='input_4_21' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_4_21_1_container' >\n                                        <input type='text' name='input_21.1' id='input_4_21_1' value=''    aria-required='true'   autocomplete=\"address-line1\" \/>\n                                        <label for='input_4_21_1' id='input_4_21_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_4_21_3_container' >\n                                    <input type='text' name='input_21.3' id='input_4_21_3' value=''    aria-required='true'   autocomplete=\"address-level2\" \/>\n                                    <label for='input_4_21_3' id='input_4_21_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_21.4' id='input_4_21_4' value=''\/><input type='hidden' class='gform_hidden' name='input_21.6' id='input_4_21_6' value='Sri Lanka' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_4_26\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_26\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Highest Educational Qualification<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_4_26'><div class='gchoice gchoice_4_26_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.1' type='checkbox'  value='G.C.E Ordinary Level'  id='choice_4_26_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_26_1' id='label_4_26_1' class='gform-field-label gform-field-label--type-inline'>G.C.E Ordinary Level<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_26_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.2' type='checkbox'  value='G.C.E Advanced Level'  id='choice_4_26_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_26_2' id='label_4_26_2' class='gform-field-label gform-field-label--type-inline'>G.C.E Advanced Level<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_26_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.3' type='checkbox'  value='Other'  id='choice_4_26_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_26_3' id='label_4_26_3' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_27\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_27\" ><label class='gfield_label gform-field-label' for='input_4_27'>Other Qualification<\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_4_27' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_4_50\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_50\" ><legend class='gfield_label gform-field-label' >Current Status:<\/legend><div class='gfield_description' id='gfield_description_4_50'>Please indicate your current status<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_50'>\n\t\t\t<div class='gchoice gchoice_4_50_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Just completed the G.C.E. A\/L'  id='choice_4_50_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_4_50\"   \/>\n\t\t\t\t\t<label for='choice_4_50_0' id='label_4_50_0' class='gform-field-label gform-field-label--type-inline'>Just completed the G.C.E. A\/L<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_50_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='University Student'  id='choice_4_50_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_50_1' id='label_4_50_1' class='gform-field-label gform-field-label--type-inline'>University Student<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_50_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Teacher'  id='choice_4_50_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_50_2' id='label_4_50_2' class='gform-field-label gform-field-label--type-inline'>Teacher<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_50_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='gf_other_choice'  id='choice_4_50_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_50_3' id='label_4_50_3' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_4_50_other' class='gchoice_other_control' name='input_50_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_51\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_51\" ><label class='gfield_label gform-field-label' for='input_4_51'>Field<\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_4_51' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_47\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_47\" ><h3 class=\"gsection_title\">Course Selection &amp; Medium of Instruction \u2013 Phase I<\/h3><div class='gsection_description' id='gfield_description_4_47'>Note: The application fee is LKR 500.00 per course, and the total amount should be paid accordingly.<\/div><\/div><fieldset id=\"field_4_38\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_2col gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_38\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Course Selection:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_4_38'>Please select the Phase I course(s) you wish to apply for:<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_4_38'><div class='gchoice gchoice_4_38_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.1' type='checkbox'  value='CCC21: Smart Devices and Internet of Things'  id='choice_4_38_1'   aria-describedby=\"gfield_description_4_38\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_4_38_1' id='label_4_38_1' class='gform-field-label gform-field-label--type-inline'>CCC21: Smart Devices and Internet of Things<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_38_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.2' type='checkbox'  value='CCC22: Python Essentials for Problem Solvers'  id='choice_4_38_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_38_2' id='label_4_38_2' class='gform-field-label gform-field-label--type-inline'>CCC22: Python Essentials for Problem Solvers<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_38_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.3' type='checkbox'  value='CCC24: Responsive Web Development'  id='choice_4_38_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_38_3' id='label_4_38_3' class='gform-field-label gform-field-label--type-inline'>CCC24: Responsive Web Development<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_38_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.4' type='checkbox'  value='CCC26: Mobile App Development'  id='choice_4_38_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_38_4' id='label_4_38_4' class='gform-field-label gform-field-label--type-inline'>CCC26: Mobile App Development<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_42\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_42\" ><legend class='gfield_label gform-field-label' >Medium of Instruction &#8211; First Preference:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_4_42'>Please indicate your first preference for the medium of instruction:<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_42'>\n\t\t\t<div class='gchoice gchoice_4_42_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Tamil Medium Batch'  id='choice_4_42_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_4_42\"   \/>\n\t\t\t\t\t<label for='choice_4_42_0' id='label_4_42_0' class='gform-field-label gform-field-label--type-inline'>Tamil Medium Batch<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_42_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='English Medium Batch'  id='choice_4_42_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_42_1' id='label_4_42_1' class='gform-field-label gform-field-label--type-inline'>English Medium Batch<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_43\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_43\" ><legend class='gfield_label gform-field-label' >Medium of Instruction &#8211; Second Preference:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_4_43'>Please indicate your second preference for the medium of instruction:<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_43'>\n\t\t\t<div class='gchoice gchoice_4_43_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='Tamil Medium Batch'  id='choice_4_43_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_4_43\"   \/>\n\t\t\t\t\t<label for='choice_4_43_0' id='label_4_43_0' class='gform-field-label gform-field-label--type-inline'>Tamil Medium Batch<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_43_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='English Medium Batch'  id='choice_4_43_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_43_1' id='label_4_43_1' class='gform-field-label gform-field-label--type-inline'>English Medium Batch<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_43_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='No Second Preference'  id='choice_4_43_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_43_2' id='label_4_43_2' class='gform-field-label gform-field-label--type-inline'>No Second Preference<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_44\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_44\" ><h3 class=\"gsection_title\">Application Fee Payments<\/h3><\/div><div id=\"field_4_49\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_49\" ><label class='gfield_label gform-field-label' for='input_4_49'>Number of Courses:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_49' id='input_4_49' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><\/select><\/div><\/div><div id=\"field_4_29\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_29\" ><label class='gfield_label gform-field-label' for='input_4_29'>Total Application Fee Paid:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_29' id='input_4_29' type='text' value='' class='large'  aria-describedby=\"gfield_description_4_29\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_4_29'> (LKR. 500.00 \u00d7 number of courses):<\/div><\/div><div id=\"field_4_31\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_31\" ><label class='gfield_label gform-field-label' for='input_4_31'>Payment Date:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_31' id='input_4_31' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_4_31_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_4_31_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_4_31' class='gform_hidden' value='https:\/\/csc.jfn.ac.lk\/expr\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_4_13\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_13\" ><label class='gfield_label gform-field-label' for='input_4_13'>Proof of Payment<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_13'>Upload a copy of your bank slip in PDF, JPEG, JPG, or PNG format.<\/div><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='5242880' \/><input name='input_13' id='input_4_13' type='file' class='large' aria-describedby=\"gfield_upload_rules_4_13 gfield_description_4_13\" onchange='javascript:gformValidateFileSize( this, 5242880 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_4_13'>Max. file size: 5 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_4_13'><\/div><\/div><\/div><fieldset id=\"field_4_22\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_4_22\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Declaration of the Candidate<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description gfield_consent_description' id='gfield_consent_description_4_22' tabindex='0'>I declare that all information provided is true and correct, and I understand that any false information may result in cancellation of my application or registration.<\/div><div class='ginput_container ginput_container_consent'><input name='input_22.1' id='input_4_22_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_4_22\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_4_22_1' >I agree to the above declaration.<\/label><input type='hidden' name='input_22.2' value='I agree to the above declaration.' class='gform_hidden' \/><input type='hidden' name='input_22.3' value='6' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_4_33\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  data-js-reload=\"field_4_33\" >&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;<br>\nSignature of Applicant<\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_4' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit Application'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_4' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_4' id='gform_theme_4' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_4' id='gform_style_settings_4' value='{&quot;inputBorderRadius&quot;:&quot;2&quot;,&quot;inputPrimaryColor&quot;:&quot;var(--ast-global-color-0)&quot;,&quot;labelFontSize&quot;:&quot;17&quot;,&quot;labelColor&quot;:&quot;#000000&quot;,&quot;buttonPrimaryBackgroundColor&quot;:&quot;var(--ast-global-color-0)&quot;}' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_4' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='4' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_4' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_4' id='gform_target_page_number_4' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_4' id='gform_source_page_number_4' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"ak_\"><label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"176\"\/><script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n<\/p><\/form>\n                        <\/div><script>\ngform.initializeOnLoaded( function() {gformInitSpinner( 4, 'https:\/\/csc.jfn.ac.lk\/expr\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', false );jQuery('#gform_ajax_frame_4').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_4');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_4').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){form_content.find('form').css('opacity', 0);jQuery('#gform_wrapper_4').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_4').addClass('gform_validation_error');} else 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