Application Form for Sri Lankan Politicians
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1. Name of Candidate : ____________ _________ __
2. Current 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 or public servising experience do you possess?
A - 1-2 yrs
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 Lanka in mind? [ ]
A - No
B - No
C - No
D - No
13. Future Best Car in mind to serve the country
A - Pajero Inter Cooler 4W
B - Merc Benz
C - Free Lander 4W
D - BMW
14. Describe your achievements in space provided:
[_________]
I hereby certifiy that the above information is true to the best of my memmory and if there some error plese excuse me
