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11/24/23, 10:40 AM Auchi Poly

P.M.B. 13 Auchi, Edo State

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Acceptance Form
Matriculation Number:AST/119230552

Registration Number : SLT/ND2324/09517


Surname Bello
Other Names Charles Imokhai
Email belloimokhaicharles@gmail.com
Phone 09064592002
Proposed Programme of
ND , SCIENCE LABORATORY TECH.
Study
Department SCIENCE LABORATORY TECH.
School APPLIED SCIENCE & TECH.

The Registrar,
Auchi Polytechnic,
P.M.B. 13,
Auchi, Edo State.
2023-11-24

Dear Sir,

ACCEPTANCE OF PROVISIONAL OFFER OF ADMISSION FOR ( 2023/24 ) SESSION

I) With reference to your letter of provisional offer of admission to the department of SCIENCE LABORATORY
TECH. Auchi Polytechnic, Edo State of Nigeria, for the 2023/24 Academic Session, I hereby indicate my
acceptance of the provisional offer upon the terms and conditions stated in the said letter of offer.

(II) I have paid the prescribed acceptance fee of (N ) to Auchi Polytechnic fees Account
(with Bank/Teller No: ). Write your name and course at the reverse side of the teller.

(III) I do/do not wish to stay in the Polytechnic's hostel.

(IV) I declare that I am not and will not be a member of any Secret Cult and further declare that I will comply with
the rules and regulations of the Auchi Polytechnic, Auchi.

(V) If I am proved to be a member of any Secret Cult, I shall accept whatever punishment that I am given for it.

Yours faithfully,

-------------------
Bello Charles Imokhai
Ensure that you quote Your Matriculation Number in all further correspondence with the School.

Note: Print 2 copies of this form and attach 2 photocopies of your credentials. Submit
along with your completed registration forms.

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