Nursing School Application Form

Full Name *

Marital Status *

Date of Birth *

Home Town *

Department *

Local Government Area *

State of Origin *

Nationality *

Primary School Name *

Date Started *

Date Ended *

Secondary School Name *

Date Started *

Date Ended *

JAMB Registration Number *

JAMB Score *

Biology Grade *

Chemistry Grade *

Physics Grade *

English Grade *

Mathematics Grade *

Bank Teller No *

Receipt No *

Phone Number *

Email Address *

Contact Address *

Permanent Home Address *

Passport Photograph * Upload a recent passport photograph (JPG, PNG, max 2MB)