Application Form for UNP/PA Politicians Application Form to Be
Filled For Contesting Sri Lankan Elections
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1. Name of Candidate : _______________________
2. Present Address
(i) Name of Jail : _______________________
(ii)Cell Number : _______________________
3. Political Party : _______________________ (List ONLY the Last Five parties in the Chronological (Order)
4. Sex: [ ]
A - Male
B - Female
C - Chandrika
D - Ranil/Mangala
5. Reasons for leaving last party (circle one or more)
A - Defected
B - Expelled
C - Bought out
D -None of above
E - All of above
6 . Reasons for contesting elections (circle one or more)
A - To make money
B - To escape court trial
C - To grossly misuse power
D - To serve the public
E - I have no clue
(if you choose "D, attach Certificate of Sanity from a Recognized Government Psychiatrist)
7. How many years of public service experience do you possess?
A - 1-2yrs
B - 2-6yrs
C - 6-15yrs
D - 15+yrs
8. Give details of any criminal cases pending against you ( Use as many Additional Sheets as you want)
9. How many years have you spent in Jail? [ ] (Do not confuse with question 8)
A - 1-2 years
B - 2-6 years
C - 6-15 years
D - 15+years
10. Are you involved in any financial scams? [ ]
A - Why not
B - Of Course
C - Definitely
D - I deny it all
E - I see a foreign hand.
11. What is your Annual Corruption Income? [ ]
A - 100-500 Rupees
B - 500-1000 Rupees
C - Overflow ...
12. Do you have any developmental plans for Sri lanaka in mind?[ ]
A - No
B - No
C - No
D - No
13. Describe your achievements in space provided: [_________]
_______________
Thumb Impression of candidate ( Not that of the person who filled theform )
Filled For Contesting Sri Lankan Elections
-----------------------------------------------------------------------
1. Name of Candidate : _______________________
2. Present Address
(i) Name of Jail : _______________________
(ii)Cell Number : _______________________
3. Political Party : _______________________ (List ONLY the Last Five parties in the Chronological (Order)
4. Sex: [ ]
A - Male
B - Female
C - Chandrika
D - Ranil/Mangala
5. Reasons for leaving last party (circle one or more)
A - Defected
B - Expelled
C - Bought out
D -None of above
E - All of above
6 . Reasons for contesting elections (circle one or more)
A - To make money
B - To escape court trial
C - To grossly misuse power
D - To serve the public
E - I have no clue
(if you choose "D, attach Certificate of Sanity from a Recognized Government Psychiatrist)
7. How many years of public service experience do you possess?
A - 1-2yrs
B - 2-6yrs
C - 6-15yrs
D - 15+yrs
8. Give details of any criminal cases pending against you ( Use as many Additional Sheets as you want)
9. How many years have you spent in Jail? [ ] (Do not confuse with question 8)
A - 1-2 years
B - 2-6 years
C - 6-15 years
D - 15+years
10. Are you involved in any financial scams? [ ]
A - Why not
B - Of Course
C - Definitely
D - I deny it all
E - I see a foreign hand.
11. What is your Annual Corruption Income? [ ]
A - 100-500 Rupees
B - 500-1000 Rupees
C - Overflow ...
12. Do you have any developmental plans for Sri lanaka in mind?[ ]
A - No
B - No
C - No
D - No
13. Describe your achievements in space provided: [_________]
_______________
Thumb Impression of candidate ( Not that of the person who filled theform )
