Announcement:

Student Portal

Student Portal:

SECTION A - PERSONAL DATA

Instructions: Fill all information required on the form below.
Last Name: *
First Name: *
Initials /Other Names: *
Maiden Name:
Contact Address: *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Telephone Number: *
Facsimile Number: *
Mobile Phone: *
Email Address: *

SECTION B - PASSPORT INFORMATION

Date Of Birth: *
Passport Number: *
Date Issue: *
Place Of Issue: *

SECTION C - OTHER INFORMATION

Sex *
FemaleMale
Marital Status: *
MarriedSingle
Height (Ft/M): *
Blood Group: *
Other Medical Condition: (In Case Of Emergency) *

SECTION D - INFORMATION ABOUT YOUR INSTITUTION

School Name: *
School Contact Address: *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
School Contact Telephone: *
Level/Class/Department *(Fill up with any of the three (3) that applicable to you)
Faculty & Course of Study Fill up this field, if you are in Higher Institution

SECTION E - NEXT OF KIN'S DATA

Instructions: FILL UP YOUR NEXT OF KIN INFORMATION IN USA
Full Name: *
Relationship: *
Contact Address: *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Telephone: *
Instructions: FILL UP YOUR NEXT OF KIN INFORMATION IN NIGERIA
Full Name: *
Relationship: *
Contact Address: *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Telephone: *

SECTION F - PERMANENT ADDRESS IN NIGERIA

Contact Address: *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Mobile Phone: *

Verification

Please enter any two digits *Example: 12
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