STUDENT REGISTRATION FORM

    --- STUDENT PERSONAL INFORMATION ---


    Marital Status
    SingleMarried


    Gender
    MaleFemale


    Date Of Birth


    Home Address

    Phone Number


    A. --- PARENT/GUARDIAN INFORMATION ---


    Parent's/Guardian's Home Address

    Phone Number


    B. --- ACADEMIC INFORMATION ---



    C. --- O' Level Academic Details ---


    S.S.C.E Results

    Subject 1
    Subject 1 Grade


    Subject 2
    Subject 2 Grade


    Subject 3
    Subject 3 Grade


    Subject 4
    Subject 4 Grade


    Subject 5
    Subject 5 Grade


    Subject 6
    Subject 6 Grade


    Subject 7
    Subject 7 Grade


    Subject 8
    Subject 8 Grade


    Subject 9
    Subject 9 Grade


    Examination Type
    NECO.NECO GCE.WAEC.WAEC GCE.NABTEB.NABTEB GCE.OTHERS.


    Subject 1
    Subject 1 Grade


    Subject 2
    Subject 2 Grade


    Subject 3
    Subject 3 Grade


    Subject 4
    Subject 4 Grade


    Subject 5
    Subject 5 Grade


    Subject 6
    Subject 6 Grade


    Subject 7
    Subject 7 Grade


    Subject 8
    Subject 8 Grade


    Subject 9
    Subject 9 Grade

    (First Sitting Attempt)
    Examination Type
    NECO.NECO GCE.WAEC.WAEC GCE.NABTEB.NABTEB GCE.OTHERS.



    Subject 1
    Subject 1 Grade


    Subject 2
    Subject 2 Grade


    Subject 3
    Subject 3 Grade


    Subject 4
    Subject 4 Grade


    Subject 5
    Subject 5 Grade


    Subject 6
    Subject 6 Grade


    Subject 7
    Subject 7 Grade


    Subject 8
    Subject 8 Grade


    Subject 9
    Subject 9 Grade


    (Second Sitting Attempt)
    Examination Type
    NECO.NECO GCE.WAEC.WAEC GCE.NABTEB.NABTEB GCE.OTHERS.


    Subject 1
    Subject 1 Grade


    Subject 2
    Subject 2 Grade


    Subject 3
    Subject 3 Grade


    Subject 4
    Subject 4 Grade


    Subject 5
    Subject 5 Grade


    Subject 6
    Subject 6 Grade


    Subject 7
    Subject 7 Grade


    Subject 8
    Subject 8 Grade


    Subject 9
    Subject 9 Grade


    D. --- Other Certifications ---



    E. --- A' Level Academic Details ---



    F. --- Preferred Study Center ---



    G. --- OTHER INFORMATION ---


    Hostel Preference; Interested?
    Yes, pleaseNo, thank you


    Physical Disabilities/Health Issues?
    YesNo


    If any disability & health challenge, please specify


    I, hereby declare that all the information given in this form is to the best of my knowledge and believed true and correct. I agree that any false or incomplete information given in this form automatically disqualifies me from being considered for the JUPEB Advanced Level Examination
    Yes, I agree to this clauseNo, I disagree with this clause


    Upload Your Passport; 1.5MB MAX SIZE