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JOINT ADMISSION AND MATRICULATION BOARD

Unified Tertiary Matriculation Examination


Application Form

168 Ijegun Road Ikotun, Alagbada Bus Stop.

Personal Data
First Name. .
Middle Name..
Surname.......................
EmailDate of Birth:

Passport Photo
Not Older than
3 months

SexMarital StatusDisability..................
GSM No..
Home Address.
Country. State..Town..Postal Code .
Nationality
Country of OriginState of OriginLocal Govt
Exam Town
State of Exam TownExam Town....................
Institution 1st Choice
Most Preferred
UNIVERSITY
Institute 1..
Course 1 ............
More Preferred
POLYTECHNIC
Institute 2
..
Course 2 .......................
Preferred
COLLEGE OF EDUCATION
Institute 3.
Course 3.....................

Institution 2nd Choice


Most Preferred
UNIVERSITY
Institute 1.
Course 1 .....................
More Preferred
POLYTECHNIC
Institute 2
..
Course 2 ...........................
Preferred
COLLEGE OF EDUCATION
Institute 3.
Course 3..........................

UTME Subjects (4 subjects including Use of English)


1. Use of English
2.
3.
4.
Candidate SSCE Type and Subjects (WAEC/NECO/GCE LONDON,ETC)
Exam TypeSSCE Subjects (minimum 5 subjects)
Subject

Grade

1.
2
3.
4.
5. ..
6. ..
7. ..
8. ..
9. ..

Maximum of 2 sittings
Important Notice: Correction of Name will attract fine of N2,500 |Correction of Institution/Course will attract fine of N2,500
Exam Town cannot be changed at anytime after the registration has been submitted

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