Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Scribd Logo
Upload

Welcome to Scribd!

  • 6 views

    Direct Entry Application Form

    Uploaded by

    victoriachiwendu17
    The document is a direct entry application form for admission to an institution that requires applicants to provide personal details, education qualifications, and references.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Direct Entry Application Form

    Uploaded by

    victoriachiwendu17
    6 views2 pages
    The document is a direct entry application form for admission to an institution that requires applicants to provide personal details, education qualifications, and references.

    Original Title

    direct_entry_application_form

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The document is a direct entry application form for admission to an institution that requires applicants to provide personal details, education qualifications, and references.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    6 views2 pages

    Direct Entry Application Form

    Uploaded by

    victoriachiwendu17
    The document is a direct entry application form for admission to an institution that requires applicants to provide personal details, education qualifications, and references.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    DIRECT ENTRY APPLICATION FORM

    PLEASE ENSURE THAT ALL FIELDS ARE COMPLETELY FILLED

    1. Deposit slip No:_________________________________________________


    2. Bank Name:____________________________________________________
    3. Branch:________________________________________________________
    4. Name:__________________________________________________________
    (Surname) (Other Names)
    5. Date of Birth:___________________________________________________
    6. Sex:____________________________________________________________
    7. Nationality:_____________________________________________________
    8. State of Origin:__________________________________________________
    9. Local Government Area:_________________________________________

    10.A DETAILS OF O’ LEVEL RESULTS 10.B DETAILS OF O’ LEVEL RESULTS


    Examination:
    Year of Examination: Examination:
    Reg. Number: Year of Examination:
    Subject(s) Grade Reg. Number:
    Subject(s) Grade

    11. JAMB DIRECT ENTRY DETAILS

    Direct Entry Login e-Facility Email


    Direct Entry Login e-Facility Password
    Direct Entry Registration Number

    Note that the Direct Entry Login e-Facility email and password required are the details
    used by Candidates while registering on JAMB e-Facility Portal .
    12. Institution Attended with Date:_____________________________________________________
    ____________________________________________________________________________________

    13. Qualification: _____________________________________________________________________

    14. Degree Applied For: _______________________________________________________________

    15. Email Address: _______________________________ Mobile Number: ____________________

    16. Applicant’s Signature/Date: _______________________________________________________

    NEXT OF KIN

    A. Name:_________________________________________________________________
    B. Place of Work:__________________________________________________________
    C. Nature of Work:________________________________________________________
    D. Relationship:__________________________________________________________
    E. Phone Number:________________________________________________________
    F. Contact Address:_______________________________________________________
    ____________________________________________________________
    G. Signature/Date:________________________________________________________

    NOTE: Attach photocopies of O’Level Results/A’ Level Result/JAMB Direct Entry


    Slip/Birth Certificate and Receipt of purchase.

    FOR OFFICIAL USE ONLY


    HEAD OF DEPARTMENT RECOMMENDATION:
    I support ( ) /I do not support ( ) the candidate’s admission.

    Comment(s)
    Level Rcommended
    Name/Signature/Date
    PROVOST’ S RECOMMENDATION:
    I support ( ) /I do not support ( ) the candidate’s admission.

    Comment(s)
    Level Rcommended
    Name/Signature/Date

    REGISTRAR’S COMMENT(S):
    --------------------------------------------------------------------------------------------------------------

    ------------------------------------ --------------------------------------
    Date Registrar’s Signature.

    ANY FALSE DECLARATION RENDERS THIS FORM/ADMISSION INVALID.

    You might also like