ADMISSION SCREENING APPLICATION FORM

Full Name *

Email *

Amount (NGN) *

Transaction Charge: , Total:

Select Screening Centre: *

Phone Number *

Sex: *

Marital Status: *

State of Origin: *

Local Government

Contact Address

O'Level Subjects with Grades. (Write AR if awaiting Result)

JAMB Reg. No.:

JAMB Score:

First Choice Programme *

Second Choice Programme *

* are compulsory
cardlogos

cardlogos