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Academic Information
Matric. No (For Freshers, Application No)
Year of Admission
Course of Study
Department of Study
College of Study
Current Level
100
200
300
400
500
Personal Information
Surname
First Name
Middle Name
Gender
Male
Female
Date of Birth (YYYY-MM-DD)
Place of Birth
State of Origin
Nationality
Nigeria
Others
Religion
Christianity
Islam
Others
Marital Status
Single
Married
Divorced
Health Challenges
Passport
(must be any of JPEG, PNG, GIF, TIFF less than 5MB)
Contact Information
Phone (0801 234 5678)
Email (abc@xyz.com)
Home Address
Parent or Guardian Information
Name (include title)
Phone (0801 234 5678)
Email (abc@xyz.com)
Permanent Home Address
