Student Member Application, Sri Lankan Engineers in South Australia

Title *

Name *

First

Last

Preferred Name

Email *

Email

Confirm Email

Phone *

Residential Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Name of the Program *

Discipline *

Length of the Program *

Type of the Program *

University

What do you expect from SLESA as an Engineering Student? ( Optional )

Feel free to add any attachments if required.

Please upload any supporting documents

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.

Digital Acceptance *

I do hereby declare that the above provided information is true and accurate to the best of my knowledge and I will provided the supporting documents if required.