Scholarship Form

Surname(*)
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First Name(*)
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Other Names
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Residential Address
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Nationality
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State
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City
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Local Govt Area
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E-mail(*)
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Phone(*)
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Date of Birth
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Gender
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Marital Status
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Religion
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Course of Study
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Upload passport
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Upload O’level result(*)
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JAMB Year [FOR ND APPLICANT ONLY]
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JAMB Registration Number
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JAMB Result

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Subject

Score

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3

4

Total

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Contact Information

Campus Address:
Ikot Idem,
Off Ikono Road,
Ikot Ekpene, Akwa Ibom State,
Nigeria.

Postal Address:
P. O. Box 1166
Ikot Ekpene, Akwa Ibom State,
Nigeria.

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