Application Form

Application Number National Identification Number Bank Verification Number

NNR36/2024/OGU/243/0021582 14303952487 2264347244

Category Exam State Exam Center

Firemen Lagos NNS QUORRA

Title Surname First Name

Mr Ogunkalu Segun

Other Name Height Religion

Mattias 1.71 Christianity

Marital Status Gender Date Of Birth

Single M Monday, September 22, 2003

State of Origin LGA of Origin Mobile Number

Ogun Ogun Waterside 08112061277

Home Town Permanent Address

Ibiade 12, Oke-Ola Street, Ita-Otu, Ogun Waterside, Ogun State

Parent/ Guardian Detail

Full Name Contact Address

Mrs. Ogunkalu 12, Oke-Ola Street, Ita-Otu, Ogun Waterside, Ogun State

Next Of Kin

Full Name Relationship Mobile Number

Ogunkalu Yemisi Hannah Sister 09123008111

Occupation Contact Address

Nursing 12, Oke-Ola Street, Ita-Otu, Ogun Waterside, Ogun State
 Application Form
Referee Details

Referee Name Phone Referee Address

Oyenuga Dayisi 08065807603 1, Amona Ogunfowora, Ilese-Ijebu, Ogun State.

Alh. Musa Maroof 08033600889 1 Araromi Musa Street, Ibiade, Ogun Waterside, Ogun State.

Primary Details
School Qualification From To

Local Government Primary School, Ita-Otu fslc 2009 2015

Secondary Details

School Qualification From To

Local Government Primary School, Ita-Otu waec 2015 2021

SSCE / NECO / WASSCE / GCE

Subject Grade Examination

Mathematics B3 GOOD 4281804124

English B3 GOOD 4281804124

Biology B3 GOOD 4281804124

Government C6 CREDIT 4281804124

Economics B3 GOOD 4281804124

Yoruba C6 CREDIT 4281804124

Civic Education E8 PASS 4281804124

Tertiary Details

Institution Course of Study Type From To Grade

 Application Form
APPLICANT'S DECLARATION

Application Number
NNR36/2024/OGU/243/0021582

Application Number: NNR36/2024/OGU/243/0021582

I Ogunkalu Segun, hereby declare that the information given in this application is true and that if found to be false I should be
prosecuted.

Signature: _______________________________ Date: _______________________________

Certification by Parents / Guardian

I _____________________________________ parent/guardian of ______________________________________, who is applying for recruitment

into the Nigerian Navy, hereby certify that I fully understand that my child/ward will (if required to) attend the Recruitment
Exercise and I shall not demand compensation or relief from the Government in respect of death or any injury which my
child/ward may sustain in the course of or as a result of any task given to him/her during the exercise.
Parent / Guardian Witness
Name: _________________________________ Name: _________________________________
Address: _______________________________ Address: _______________________________
Signature: _______________________________ Signature: _______________________________
Date:_______________________________ Date:_______________________________
 Application Form
LOCAL GOVERNMENT AREA CERTIFICATION

Application Number
NNR36/2024/OGU/243/0021582

Title Surname First Name

Mr Ogunkalu Segun

Other Name Height Religion

Mattias 1.71 Christianity

Marital Status Gender Date Of Birth

Single M Monday, September 22, 2003

State of Origin LGA of Origin Mobile Number

Ogun Ogun Waterside 08112061277

Home Town Permanent Address

Ibiade 12, Oke-Ola Street, Ita-Otu, Ogun Waterside, Ogun State

Certification by LGA Chairman / Secretary Or Senior Military Officer not below

the rank of Commander or equivalent Or Chief Superintendent Of Police from
Applicant's State of Origin
I certify that the applicant ____________________________________________ is an indigene of _____________________________ L.G.A,
________________ State, and that to the best of my knowledge and belief, the facts stated on the form are correct. I hereby
declare that if any statement made in connection with this application is proven to be false I should be prosecuted.

Name:_____________________________________________________________________
Address:________________________________________________________________________________________
Signature:_________________________________________
Date:_________________________________________
 Application Form
POLICE CERTIFICATION

Application Number
NNR36/2024/OGU/243/0021582

Title Surname First Name

Mr Ogunkalu Segun

Other Name Height Religion

Mattias 1.71 Christianity

Marital Status Gender Date Of Birth

Single M Monday, September 22, 2003

State of Origin LGA of Origin Mobile Number

Ogun Ogun Waterside 08112061277

Home Town Permanent Address

Ibiade 12, Oke-Ola Street, Ita-Otu, Ogun Waterside, Ogun State

Certification by LGA Chairman / Secretary Or Senior Military Officer not below the rank of
Commander or equivalent Or Chief Superintendent Of Police from Applicant's State of Origin
I certify that the applicant ____________________________________________ is an indigene of _____________________________ L.G.A,
________________ State, and that to the best of my knowledge and belief, the facts stated on the form are correct. I hereby
declare that if any statement made in connection with this application is proven to be false I should be prosecuted.
Name:_____________________________________________________________________
Address:________________________________________________________________________________________
Signature:_________________________________________
Date:_________________________________________
Certification by Divisional Police Officer
I certify that the applicant _________________________________ is an indigene of ______________________Town, _________________________
L.G.A, ________________ State and that his/her parent hails from __________________________ L.G.A. of _________________ State. That
he/she has no criminal record on him/her. (If any state briefly
_________________________________________________________________________________________________________________________________________________
That to the best of my knowledge and belief the facts stated in the form are correct and I hereby declare that if any
statement made in connection with this application is proven to be false I should be prosecuted.

Name:_______________________________
Address:_______________________________
Signature:_______________________________
Date:_______________________________
 GUARANTOR'S FORM

Application Number
NNR36/2024/OGU/243/0021582

Title Surname First Name

Mr Ogunkalu Segun

Other Name Height Religion

Mattias 1.71 Christianity

Marital Status Gender Date Of Birth

Single M Monday, September 22, 2003

State of Origin LGA of Origin Mobile Number

Ogun Ogun Waterside 08112061277

Home Town Permanent Address

Ibiade 12, Oke-Ola Street, Ita-Otu, Ogun Waterside,
Ogun State

Particulars of Guarantor

Surname: ______________________________________ First Name: ____________________________________

Middle Name: _________________________________ Town: _________________________________________
LGA: __________________________________________ State of Origin: ________________________________
Mobile: ________________________________________ E-mail: ________________________________________
Appointment: __________________________________ How long have you known the candidate:_______
Formation/Unit/Office Address: _________________________________________________________________
Residential Address: ___________________________________________________________________________
Contact Address: ______________________________________________________________________________
Name: ______________________________________
Address: __________________________________________________________________________
Signature:__________________________________________
Date:________________________________________

This form is to be filled by a Military Offi cer not below the rank of Lt Col or equivalent/Police Offi cer not below the
rank of Chief Superintendent of Police/Assistant Director at either Federal or State Civil Service certifying the
eligibility of the applicant. You need not to come from an applicant’s State of Origin to guarantee him/her only be sure of the
character. Please note that inability to confirm the above given information about you, will lead to automatic disqualification
of the candidate.
 Application Form
FOR OFFICIAL USE ONLY

Application Number: NNR36/2024/OGU/243/0021582

Applicant's Full Name: Ogunkalu Segun
Date Received:_____________________________________
Education Qualification: Number Of Credits/Passes obtained (SSCE / GCE / WASCE / NECO):_______
Documents Attached
a)_____________________________________________________
b)_____________________________________________________
c)_____________________________________________________
d)_____________________________________________________
e)_____________________________________________________
Detailed Result
Medical fitness:_____________________________________________________
General aptitude test score:_____________________________________________________
Vocational aptitude test score:_____________________________________________________
Remark
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________

Rank:_____________________________________________________
Name:_____________________________________________________
Signature and Date:_____________________________________________________
Director
Rank:_____________________________________________________
Name:_____________________________________________________
Signature and Date:_____________________________________________________