Surname:

First Name:

Middle Name:

Sex:
Male Female

Date of Birth:

Nationality:

State of Origin:

L.G.A.:

Religion:

Denomination:

Class For Admission:

Present Class:

Please, affix your most recent coloured passport photograph here

Candidate’s Passport Photograph:

2. RECORD OF SCHOOLS ATTENDED

School Last Attended:

Date:

Any Other:

Date:

Attach photocopy of last school’s result sheet:
File:

3. PARENTS’ OR GUARDIANS’ INFORMATION

Name of Father:

Business Address:

Phone (business):

Residential Address:

Phone (personal):

Email:

Name of Mother:

Business Address:

Phone (business):

Residential Address:

Phone (personal):

Email:

Name of Guardian:

Business Address:

Phone (business):

Residential Address:

Phone (personal):

Email:

4. ADDITIONAL INFORMATION

Hobbies:

Special Talents:

ATTESTATION
We declare the information supplied is accurate in every detail. 

Agree