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Name *

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Last

Email *

Phone

Permanent Home Address: *

Address Line 1

City

State / Province / Region

Contact Address: *

Address Line 1

City

State / Province / Region

Next of Kin Name *

First

Last

Next of Kin/Contact Address: *

Address Line 1

City

State / Province / Region

Sponsor’s Address: *

Address Line 1

City

State / Province / Region

D.O.B *

Sponsor’s Name *

First

Last

Faculty *

Mode of Entry *

O/L Exam Result *

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O/L Result Month/Year//

O/L Exam Result *

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O/L Result Month/Year//

Disability *

I hereby declare that the particulars on this form are to the best of my knowledge and that at any time the University is reasonably satisfied that any of the information I have given on this Registration Form is false or incorrect, I will be required to withdraw from the University or be liable to be prosecuted or both.

I hereby declare that the particulars on this form are to the best of my knowledge and that at any time the University is reasonably satisfied that any of the information I have given on this Registration Form is false or incorrect, I will be required to withdraw from the University or be liable to be prosecuted or both.

I confirm, after examing the above, that this student possesses the minimum qualifications for entry into the course for which he/she is duly registered.

I confirm, after examing the above, that this student possesses the minimum qualifications for entry into the course for which he/she is duly registered.

Admission Letter

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Birth Certificate *

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LGA Certificate *

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