Application Information

Form Should be completed in CAPITAL LETTERS. All fields Must be filled and also tick as appropriate Endeavour to upload your Image to complete the registration process.

SECTION A

1. Personal Information

NAME

First Name*

Last Name*

Other Name*

DATE OF BIRTH

GENDER

Female

Male

TITLE [Mr, Mrs, Dr, Chief, etc]

PLACE OF BIRTH

MARITAL STATUS

Single

Married

Divorce

NATIONALITY*

STATE OF ORIGIN*

LOCAL GOVT AREA *

HOME TOWN *

 2. CONTACT DETAILS

RESIDENTIAL ADDRESS/HOUSE NUMBER*

STREET NAME*

NEAREST BUSTOP/LANDMARK*

CITY/TOWN*

STATE*

PERMANENT HOME ADDRESS*

PHONE NUMBER 1*

PHONE NUMBER 2*

EMAIL*

 3. VALID MEANS OF IDENTIFICATION

INT'L PASSPORT

OTHERS

ID ISSUED DATE*

SECTION B

PARENT / GUARDIAN / SPONSOR DATA

SURNAME*

GENDER

FEMALE

MALE

FIRST NAME*

OTHER NAMES*

DATE OF BIRTH*

RELATIONSHIP*

NATIONALITY*

PHONE NUMBER 1*

PHONE NUMBER 2*

EMAIL*

RESIDENTIAL ADDRESS /HOUSE NUMBER*

STREET NAME*

NEAREST BUSTOP/LANDMARK*

CITY/TOWN*

LGA*

STATE*

SECTION C

COURSE APPLIED FOR

FIRST CHOICE*

SECOND CHOICE*

THIRD CHOICE*

QUALIFICATIONS

ACADEMIC QUALIFICATIONS

WAEC

GCE

NECO

DIPLOMA

SCHOOLS ATTENDED*

DATE OF COMPLETION*

PROFESSIONAL QUALIFICATIONS*

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