08033362449, 08033257884 Information department

 
SECTION A:       PROPOSED PROGRAMME OF STUDY
MODE OF PROGRAMME:
SCHOOL CENTER:
PROGRAMME OF STUDY:

FIRST CHOICE:  
SECOND CHOICE:  

INSTRUCTION:This form must be compleated in CAPITAL LETTERS.
SECTION B: PERSONAL DATA
Title:  
Surname:  
OtherNames:  
DateOfBirth:
 
EMail:    
Sex:
PlaceOfBirth:
Nationality:  
StateOfOrigin:
LGA Of Origin
ResidentAddress:  
PostalAddress:
Phone:
EDUCATIONAL RECORDS
PLEASE PROVIDE THE EXAM RECORD YOU ARE INTENDING TO USE IN OBTAINING ADMISSION
SN SUBJECT GRADE EXAM TYPE
1
2
3
4
5
6
7
8
9
10
11
 
Next Of Kin Information
Name & Addr. Of NextOfKin:
RelationShip WithNextOfKin:
Back to Top