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Application Form for Admission
Please read the following instructions carefully:
Applicants for Pre-ND programmes of the Polytechnic must register and sit for the 2016 UTME. They must score the national minimum pass-mark which will be determined by JAMB for the year as a pre-condition for eventual admission into ND I.
The Certificate Course in ICT proficiency is for a period of three (3) months, to be followed by another three (3) months of specialized training in ICT leading to the award of Advanced Certificate in ICT proficiency (with specialization).
The Certificate Course in Accounting will run for a period of Six (6) months.
Passport
Application forms can also be obtained at the Office of the Registrar of the Polytechnic.
1. Personal Details (Please complete in BLOCK CAPITALS)
Title:
Mr
Miss
Mrs
Dr
Gender:
Female
Male
Surname:
Maiden Name(where applicable):
Other Names:
Date of birth:
Marital Status:
Single
Married
Divorced
Correspondence Address:
Home Address :
Email:
LGA:
Home Town:
State Of Origin:
Abia
Adamawa
Akwa Ibom
Anambra
Bauchi
Bayelsa
Benue
Borno
Cross River
Delta
Ebonyi
Edo
Ekiti
Enugu
Gombe
Imo
Jigawa
Kaduna
Kano
Katsina
Kebbi
Kogi
Kwara
Lagos
Nasarawa
Niger
Ogun
Ondo
Oyo
Plateau
Rivers
Sokoto
Taraba
Yobe
Zanfara
Abuja
Telephone Numbers
Mobile:
Other contact Number:
2. Tick the programme you are applying for
Name Of programme
Tick as appropriate
Pre-ND Programme
Accountancy
Computer Science
Computer Engineering
Statistics
Electrical & Electronic Engineering
Certificate Courses
Accountancy
ICT
Diploma Programmes
Management
Printing and Publishing
Advanced Certificate Course in ICT with specialization in:
a. System Maintenance
b. Networking
c. Programming & Web Development
(a)
(b)
(c)
3. Qualifications Obtained
Please list all subjects passed at O’ Level (WASCE, GCE , NECO, NABTEB, or any other relevant certificates)
Name of School:
Year Awarded:
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
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1981
1980
1979
1978
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1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
Name of School:
Year Awarded:
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
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1991
1990
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1981
1980
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1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
Serial No
Subject
Grade
Serial No
Subject
Grade
1
1
2
2
3
3
4
4
5
5
6
6
7
7
8
8
9
9
4. Information on Parents or Guardians
Give details of Parents, Guardians or Sponsors
Full Names:
Address:
Phone Number:
Relationship with the Applicant:
Occupation:
5. Payment Information
Remita Number (Make the necessary payment on remita.com):
6. DECLARATION (Tick the checkbox to confirm)
I declare that the information I have provided in this form is true. I declare that if offered admission, I shall obey the rules and regulations of the Polytechnic as applicable to students.