Sixth Form Admission Form

APPLY NOW SIXTH FORM 17 - 18 Years SECONDARY 10 - 17 YEARS PRIMARY 5 - 10 YEARS

STUDENT’S INFORMATION

Child's Name

First

Last

Child’s date of birth

Gender:

State of Origin:

Nationality:

Current School:

Application into:

LGA:

Religion:

Results obtained:

Proposed Year of Admission:

Proposed Subjects:

PARENT/LEGAL GUARDIAN INFORMATION

FATHER/LEGAL GUARDIAN

Name

First

Last

Postal Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Home Telephone:

Occupation:

Mobile Number:

Nationality:

Name of Employer:

Address of Employer:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

How did you learn about GIS?

Date of assessment

Signature of parent/guardian:

Signature date:

MOTHER/LEGAL GUARDIAN

Name

First

Last

Postal Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Home Telephone:

Occupation:

Mobile Number:

Nationality:

Name of Employer:

Address of Employer:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

How did you learn about GIS?

Date of assessment

Signature of parent/guardian:

Signature date:

STUDENT’S INFORMATION

PARENT/LEGAL GUARDIAN INFORMATION

FATHER/LEGAL GUARDIAN

MOTHER/LEGAL GUARDIAN