Full Name (Surname First) * Date of Birth * Sex *FemaleMale Nationality * State of Origin *Select State / FCTAbiaAdamawaAkwa IbomAnambraBauchiBayelsaBenueBornoCross RiverDeltaEbonyiEdoEkitiEnuguFCT AbujaGombeImoJigawaKadunaKanoKatsinaKebbiKogiKwaraLagosNasarawaNigerOgunOndoOsunOyoPlateauRiversSokotoTarabaYobeZamfara Local Government Area (LGA) * ReligionChristianityIslamOther Blood Group / Genotype Passport Photograph (JPG/PNG)

Class Applying Into * JSS1 JSS2 JSS3 SS1 SS2 SS3 Primary 1 Primary 2 Primary 3 Primary 4 Primary 5 Primary 6 Nursery 1 (Exempt from prior schooling) Nursery 2 Nursery 3 Crèche (Exempt from prior schooling) Previous School Attended * Last Class Completed Medical / Allergy Notes (Optional)

Parent / Guardian Full Name * Telephone / WhatsApp Number * Email Address * Residential Address *