© NOT FOR SALE. DO NOT PAY FOR THE TEMPLATE = UTME 2024 REGISTRATION TEMPLATE = ‘A __ ESSENTIAL INFORMATION (MUST AGREE WITH NIMC) ves [] no [] PROFILE CODE: I ] PIN: Surmame: First Name: Middle Name: Date of Birth Sex: Marital Status Maiden Name if Married: Previous Name: HAVE YOU MADE ANY C ION TO YOUR mobitenumber:[ | | | I BIODATA WITH NIMC?| Nationality: State of Origin:. LGA: BOTHER INFORMATION Disabilities/Challenges: Blind] Deaf] oumb[] Albino[] tame] others] None] Contact Address: Preferred State of Exam: Exam Tow! Interested in JAMB Mock Exam: YES{_] NO[_] __ CHOICES OF INSTITUTION Candidates are to NOTE that their 1st choice can also be @ College of Education, University, Innovation Enterprise Institute, Polytechnic/Monotechnic, NDA (Nigerian Defence Academy) or Nigeria Police Academy. Ast Choice (Degree/ND/NCE): Programme of study: 2nd Choice (Institution): Programme of study: 3rd Choice (Institution): Programme of study: 4th Choice (Institution): Programme of study: D UTME SUBJECTS 1] USE OF ENGUSH 2 NAME OF SECONDARY SCHOOLATTENDED: O'LEVEL SUBJECTS ‘GRADE | WAEC, NECO,NABTEB] SCHOOL/PRIVATE] YEAR] EXAM NOs supplied the above information. Sgnature & Date: FOR STAFF ONLY Processed by;, Signature & Date: Remark: