Admission Form

Student’s Information

Full Name

Date of Birth

Gender MaleFemaleOther

Place of Birth

Religion ChristianityIslamTraditionalOther

Nationality

State of Origin AbiaAdamawaAkwa IbomAnambraBauchiBayelsaBenueBornoCross RiverDeltaEbonyiEdoEkitiEnuguFCTGombeImoJigawaKadunaKanoKatsinaKebbiKogiKwaraLagosNasarawaNigerOgunOndoOsunOyoPlateauRiversSokotoTarabaYobeZamfara

LGA

Residential Address

Passport Photograph

Admission Details

Class Applying For Nursery 1Nursery 2Nursery 3Primary 1Primary 2Primary 3Primary 4Primary 5Primary 6JSS 1JSS 2JSS 3SS 1SS 2SS 3

Preferred Term FirstSecondThird

Previous School

Last Class Completed

Reason for Transfer

Parent/Guardian Information

Father’s Name

Father’s Occupation

Father’s Phone

Father’s Email

Mother’s Name

Mother’s Occupation

Mother’s Phone

Mother’s Email

Guardian (if different)

Emergency Contact

Name

Relationship

Phone

Medical Information

Any Medical Condition? YesNo

If Yes, specify

Allergies

Blood Group A+A-B+B-AB+AB-O+O-

Genotype AAASSSACOther

Documents Upload

Birth Certificate

Report Card

Immunization Record

Declaration

I certify that the information provided is correct.I understand that false information may lead to disqualification.I consent to the school storing and processing my child’s data.