FEZZAN NIGERIA LIMITED.

AKK SKILL TRANSFER APPLICATION FORM.

**This is a sample form. Please visit www.fezzan.ng to apply for the programme**

SIGN UP

Name

Surname

Middle Name

First Name

Identification

Phone Number

Email

National Identity Number

Date of Birth (DD/MM/YYYY)

State Of Origin & Residency

State Of Origin Residency

**This is information about your state and *This is information about where you currently
local government of origin* live. Repeat if same as State of origin.*

State

L.G.A

City

House No and
Street Name
[Current address}
 FEZZAN NIGERIA LIMITED.
AKK SKILL TRANSFER APPLICATION FORM.
**This is a sample form. Please visit www.fezzan.ng to apply for the programme**

TRAINING SELECTION

First ❏ Welding ❏ Scaffolding ❏ Non-Destructive ❏ Pipe Fitting

Choice Testing

Do you have relevant industry experience in the selected field? Yes/No

If yes; Name of Employer [ If Self employed State your Name]

Position Held

From[dd/mm/year] : To: [dd/mm/year]:

Description of Duties: [ Kindly describe the responsibilities you held while you worked at the organisation]

* [Incase you can not get your first choice, which other field would you like to be trained in]
Second ❏ Welding ❏ Scaffolding ❏ Non-Destructive ❏ Pipe Fitting
Choice Testing

Do you have relevant industry experience in the selected field? Yes/No

If yes; Name of Employer [ If Self employed State your Name]

Position Held

From[dd/mm/year] : To: [dd/mm/year]:

Description of Duties: [ Kindly describe the responsibilities you held while you worked at the organisation]
 FEZZAN NIGERIA LIMITED.
AKK SKILL TRANSFER APPLICATION FORM.
**This is a sample form. Please visit www.fezzan.ng to apply for the programme**

TRAINING SELECTION

Are you Currently employed?

If yes; Name of Employer [ If Self employed State your Name]

Address:

Position Held

From[dd/mm/year] : To: [dd/mm/year]:

Description of Duties: [ Kindly describe the responsibilities you carry out]

Previous Employment??

If yes; Name of Organisation

Address:

Position Held

From[dd/mm/year] : To: [dd/mm/year]:

Description of Duties: [ Kindly describe the responsibilities you held while you worked at the organisation]
 FEZZAN NIGERIA LIMITED.
AKK SKILL TRANSFER APPLICATION FORM.
**This is a sample form. Please visit www.fezzan.ng to apply for the programme**

Previous Employment??

If yes; Name of Organisation

Address:

Position Held

From[dd/mm/year] : To: [dd/mm/year]:

Description of Duties: [ Kindly describe the responsibilities you held while you worked at the organisation]

Previous Employment??

If yes; Name of Organisation

Address:

Position Held

From[dd/mm/year] : To: [dd/mm/year]:

Description of Duties: [ Kindly describe the responsibilities you held while you worked at the organisation]
 FEZZAN NIGERIA LIMITED.
AKK SKILL TRANSFER APPLICATION FORM.
**This is a sample form. Please visit www.fezzan.ng to apply for the programme**

Are you currently a student in any Institution of Higher Learning?Yes/No

If yes; Name of Institution?

State the Institution is located in.

What is highest education qualification you have attained? *

[SSCE, ND, HND/BTEC, BSC, PgDip, MSC, PHD]

Name of Awarding Institution or Body *

Field of Study [Engineering, Physical Sciences or specify]

Course of Study

TRAINING DATA

Protective Coverall Size Safety Steel Toe boot size

Clothing **
❏ S ❏ M ❏ L ❏ XL ❏ XXL

Do you have Asthma? Blood Group:

Medical
Information ❏ YES ❏ NO ❏ A ❏ B AB ❏ O
Do you have any
other medical
condition?

If Yes, please
describe

Bank Name:
Banking
Information

Account Name: Account Number: