Application Form FR/POED/00937/2023

Bank account no: 97249000180030370000937230

Study: 3-year Bachelor of Nursing programme
Sex: Male
Full name:Kabiru Tunde Olatunji
Date of birth: 02-02-1989
Place of birth: Lagos (Nigeria)
Father's first name: Rauf Mother's first name: Taiwo
Permanent address: 234 Ikeja (Nigeria, Lagos), Igbasan Street Opebi Ikeja Lagos 11
Address for correspondence: 234 Ikeja (Nigeria, Lagos), Igbasan Street Opebi Ikeja Lagos 11
Phone: 07035147623, Mobile: 07035147623, Skype: , Email: toniadebibi@yahoo.com
Nationality: Nigeria, citizenship:Nigeria , country of permanent residence: Nigeria, country of origin: Nigeria
Source agency: University Admissions Office, Medical University of Gdańsk
Passport: B50197325 (Nigeria), 2022-07-14 - 2027-07-13
Secondary school details: Opebi senior grammar school, City (2002 - 2009)
Secondary school certificate details: West African Examinations Council Senior School Certificate, number 5250123296, issued
2011-12-15
Names of the Universities attended: Wolex polytechnic, Osun state polytechnic iree
Experience in scientific work: Yes
English speaking level: A2 - Basic User - (Elementary) English writing level A2 - Basic User - (Elementary)
Polish speaking level: lack Polish writing level: lack
English Language Certification: secondary
Source of financing: other
Anti-Hepatitis B vaccination: No
Information source about University: other
I declare that while completing the application form, I have read the full recruitment clause (including the clause on the handling
of personal data) and I accept their content.

Ikeja 2023-06-17 .......................................................

(Applicant‘s Signature)

Admissions Office, Medical University of Gdansk

al. Zwyciestwa 41-42, 80-210 Gdansk, Poland | +48 58 349 13 92 | admission@gumed.edu.pl