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New Student Application Form
Untitled Document
Phase 1 of 3
SECTION A
Candidate Type*:
New Students
JSS2
SS1
SS2
supplementary New Students
PHOTOGRAPH*:
(MAXIMUM 90KB)
SECTION A(TO BE FILLED BY THE CANDIDATE)
SURNAME:
FIRST NAME*:
SEX*:
FEMALE
DATE OF BIRTH*:
JANUARY
FEBRUARY
MARCH
APRIL
MAY
JUNE
JULY
AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2014
2013
2012
2011
2010
2009
2008
2007
STUDENT'S E-MAIL ADDRESS*:
LOCAL GOVERNMENT AREA*:
HOME ADDRESS*:
POSTAL ADDRESS*:
TELEPHONE NO*:
LAST CLASS AND YEAR*:
LAST PRIMARY SCHOOL ATTENDED*:
CHOOSE YOUR EXAMINATION CENTRE*:
Presentation National High school, Benin city, Edo State
Regina Mundi(OLA) Private School, Asaba Delta Sate
LUMEN CHRISTI INTERNATIONAL HIGH SCHOOL, ARUE, UROMI, EDO STATE
Mater Misericordiac Catholic Church, Rumuomasi PH
AUNTY ROSE SCHOOL, WARRI, Delta State
Eucharistic Heart of Jesus Model Secondary School, 34, Gado Nasco Way, Kubwa Abuja.
St. Leos Primary School, Ikeja Lagos
St. Mulumbas Catholic Church New Heaven Enugu
Holy Martyrs Of Uganda MMinor Seminary, Warri, Delta Stat.
SECTION B (TO BE FILLED BY THE PARENTS)
FATHER'S NAME*:
STATUS AND RANK*:
DEPARTMENT/OFFICE*:
FATHRE'S EMPLOYER*:
RESIDENTIAL ADDRESS*:
CONTACT ADDRESS (Not P.O. Box):
FATHER'S E-MAIL*:
MOTHER'S NAME*:
MOTHER'S STATUS AND RANK*:
MOTHER'S EMPLOYER*:
DEPARTMENT/OFFICE:
RESIDENTIAL ADDRESS:
CONTACT ADDRESS (Not P.O. Box)*:
MOTHER'S E-MAIL*:
ATTACH LAST RESULT OF PRESENT CLASS*:
(For Multiple, files Compress as a Zip)
WHO IS RESPONSIBLE FOR THE CHILD'S SCHOOL FEES AND OTHER FINANCIAL COMMITMENT?:
SECTION C (OTHERS)
Blood Group:
A
B
O
O+
O-
Genotype:
AA
AS
SS
Height:
ft
Weight:
kg
Colour of Eyes:
Black
Brown
Green
Blue
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