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COLLEGE OF EDUCATION

P.M.B.1251,
WARRI
DELTA STATE, NIGERIA.
www.ijmbwarri.com.ng
coordinator@ijmbwarri.com.ng
abuijmbcoe.warri@gmail.com

Ref: COE/ABU/IJMB/HR/201 /
201 /
INTERIM JOINT
MATRICULATION BOARD
(IJMB)
EXAMINATION PROGRAMME
OF THE
AHMADU BELLO UNIVERSITY,
ZARIA.
ADMISSION APPLICATION
FORM

AFFIX YOUR SIX
RECENT
PASSPORT –
SIZED
PHOTOGRAPH
HERE

IMPORTANT NOTICE:
Applicants are advised to read through this form carefully before
completing it, photocopy of receipt of payment teller must be
attached.

Applicants who submit more than one application form or use one
receipt for more than one set of forms, or fail to complete the form
properly will be disqualified.
IJMB UNIT. COLLEGE OF EDUCATION, WARRI

PERSONAL DATA:
Surname : First Name:

Other Name: Sex:

Permanent Home Address: Residential address:

Marital Status Maiden Name:

Phone (GSM) No: Telephone (Residential):

E-mail: Date of Birth:

Next – of - kin: State of Origin:

Phone(GSM) of next-of-kin:

Local Govt Area: Nationality:

Extra Curricula Activates Name of Parent:

Occupation of parent Phone(GSM) of Parent:

CHOICE OF COURSE/SUBJECT
A’ Level Subject / Course O’ Level Subject / Course
( please tick as appropriate)
1 Mathematics
2 English Language
3

ACADEMIC RECORDS:

Primary and Post –primary institution attended with dates:

S/ Name of Institution From To Qualification
N obtained
SCHOOL CERTIFICATE RESULT: WAEC/NECO SSCE / NABTEB/ OTHER (FIRST
SITTING)

Name of Date of Examinati Subjects Grades
Examination Examinati on
on Number

SCHOOL CERTIFICATION RESULTS: WAEC/NECO/SSCE/NABTEB/OTHERS
(SECOND SITTING)

Name of Date of Examinatio Subject Grades
Examination Examinatio n Number
n

Important Note:
(a) Indicate clearly the name of each examination.
(b) If credentials are enclosed, marks “X”

DECLARATION:
I,
…………………………………………………………………………………………….
hereby declare that the information given in this form, is to the best of
my knowledge and belief, correct. Any false or incomplete information
given in this form will automatically disqualify me from being
considered for admission to, or continuing with any course of study in
Ahmadu Bello University, Zaria (ABU) IJMB Programme affiliate of
College of Education, Warri.
I shall accept as final, the decision of the IJMB Unit, College of
Education, Warri with regard to my course(s) of study and placement
in the IJMB programme.

…………………………………………………………………………
Applicant’s Signature and Date

ATTESTATION:
I hereby confirm that this applicant is known to me. The information
supplied in his/her form is, to the best of my knowledge, true. The
attached passport-sized photograph, endorsed by me, is true
resemblance of the applicant.

Full Name: --------------------------------------------------------------------------
Address: -----------------------------------------------------------------------------
Occupation: -------------------------------------------------------------------------
Signature: ----------------------------------------------------------------------------
Post Held: -----------------------------------------------------------------------------
Date: ----------------------------------------------------------------------------------

FOR OFFICE USE ONLY
Date of Issue
Date Returned
Date acknowledgement was
sent
Registration Number
Qualified /Not Qualified
Admitted / Not Admitted

COLLEGE OF EDUCATION
P.M.B.1251,
WARRI
DELTA STATE, NIGERIA.
www.ijmbwarri.com.ng
E-mail: abuijmbcoe.warri@gmail.com
coordinator@ijmbwarri.com.ng
08036707695
IJMB UNIT.

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