Student Registration Form

Excellence in Character, Learning, Ingenuity, and Productivity.

Full Name *

Email *

Amount (NGN) *

Minimum payable amount NGN 10,500

Enter Residential Address

Enter Date of birth

Enter Place of birth

Enter State of Origin

Enter Nationality

Disability

YesNo

Enter Phone Number

Parent/Guardian Details (Father/Male Guardian)

Enter Surname

Enter First name

Enter Middle name

Enter Occupation

Enter Relationship with student

Enter Phone number (WhatsApp preferable)

Enter Email

Parent/Guardian Details (Mother/Female Guardian)

Enter Surname

Enter First name

Enter Middle name

Enter Occupation

Enter Relationship with student

Enter Phone number (WhatsApp preferable)

Enter Email

* are compulsory
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