number:

Password

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Ensure all the information provided is accurate and correct.

SECTION A BIODATA

Name(surname first):

Sex:

Date of Birth:

Mobile Number:

preferred study centre:

Address:

State of Residence:

State of Origin:

LGA:


SECTION B
PARENTS/GUARDIAN DETAILS

Name:

Address:

Occupation:

Mobile Number:


SECTION C
ACADEMIC RECORD

Primary school:

Secondary school:


O'LEVEL RESULT DETAILS

NOTE (i) Candidates whose subject grades are not available as of the time of this registration should just indicate "Awaiting Result "
(ii) for candidates using 2sittings, 6 compulsory subjects that correspond to their course in the two results should be entered.

WAEC/NECO/NABTEB/GCE REGISTRATION NUMBER:


Examination year:

Subject one:
Grade:


Subject two:
Grade:


Subject three:
Grade:


Subject four:
Grade:


Subject five:
Grade:


Subject six:
Grade:


SECTION D
INSTITUTION OF CHOICE AND COURSE


first choice University :

second choice university:


course of study:


PROPOSED A'LEVEL SUBJECTS


subject one:

Subject two:

subject three:



Attestation : I : hereby solemnly attest that all the information provided in this application form is true and correct and any falsification of information disqualifies me from being admitted
Date:


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