Student Enrollment

Online Student Registration Form

Please fill this form with your genuine details. NB: Fields marked with * are mandatory.

Basic Info

First Name *

Please Enter First Name

Other Names

Please Enter Other Names

Last Name *

Please Enter Last Name

Father's Name *

Please Enter Father's Name

Father's Occupation *

Please Enter Father's Occupation

Mother's Name *

Please Enter Mother's Name

Mother's Occupation *

Please Enter Mother's Occupation

Phone *

Please Enter Phone

Email *

Please Enter Email

Gender *

Please Enter Gender

Date Of Birth *

Please Enter Date Of Birth

Emergency Phone *

Please Enter Emergency Phone

Religion *

Please Enter Religion

Nationality *

Please Enter Nationality

Marital Status *

Please Enter Marital Status

Blood Group

Please Enter Blood Group

National ID No. (NIN)

Please Enter National ID No. (NIN)

Admission Year *

Please Enter Admission Year

Present Address -

State *

Please Enter State

Town/City *

Please Enter Town/City

Full Address (House No, Street & LGA) *

Please Enter Full Address (House No, Street & LGA)

Permanent Address -

State *

Please Enter State

Town/City *

Please Enter Town/City

Full Address (House No, Street & LGA) *

Please Enter Full Address (House No, Street & LGA)

Educational Info

SSCE Information

School Name *

Please Enter School Name

Exam Reg. No. *

Please Enter Exam Reg. No.

Graduation Year *

Please Enter Graduation Year

No. of Credits *

Please Enter No. of Credits

Academic Information

Matriculation No. *

Please Enter Matriculation No.

Batch *

Please Enter Batch

Department *

Please Enter Department

Level *

Please Enter Level

Status

Please Enter Status

Guardians information

Relationship with Guardian *

Please Enter Relationship with Guardian

Name *

Please Enter Name

Occupation *

Please Enter Occupation

Email *

Please Enter Email

Phone *

Please Enter Phone

Full Address (House No, Street & LGA) *

Please Enter Full Address (House No, Street & LGA)

Documents

Passport Photograph: Best Resolution Height- 300 PX, Width- 300 PX

Please Enter Passport Photograph

I have reviewed all the information provided in this application form, and hereby declare that they are true and accurate to the best of my knowledge.

Please agree that you have provided the correct information.