Name of Pupil (Applicant)*
Gender * Select Male Female
Present School

Date Of Birth *

Class of interest * Select Creche Pre-Kindergarten KG 1 KG 2 KG 3 Primary 1 Primary 2 Primary 3 Primary 4 Primary 5 Primary 6

PARENTS/GUARDIAN INFORMATION

Parent Title None Mr. Mrs. Mr. & Mrs Dr. Prof. Pastor Rev. Bar. Chief. Hon. HRH Others
Father's First Name *
Father's SurName *
Mother's Full Name *
Father's Occupation
Mother's Occupation *
Contact Address *
Nationality *
State of Origin * - Select - Abia Adamawa AkwaIbom Anambra Bauchi Bayelsa Benue Borno Cross River Delta Ebonyi Edo Ekiti Enugu FCT Gombe Imo Jigawa Kaduna Kano Katsina Kebbi Kogi Kwara Lagos Nasarawa Niger Ogun Ondo Osun Oyo Plateau Rivers Sokoto Taraba Yobe Zamfara LGA of Origin
Religion *
Father's Phone number *
Father's Email Address
Father's office Address*
Mother's Phone number *
Mother's Email Address
Mother's office *
Mother's office Address *
How did you Hear about us* None Tv.Advert Radio. A Parent Website Fliers Sign Post Social media Others
Cost of Form ₦10,000

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