NIGER DELTA UNIVERSITY

WILBERFORCE ISLAND, BAYELSA STATE

STUDENTS DATA FORM

Section A: Bio Data

1. Name: JOEL ISIVIE EMMANUEL

Maiden Name (if applicable):
2. First Name:
3. Middle Names:
4. Gender: MALE
5. Marital Status: SINGLE
6. Date of Birth: 2005-01-25
7. Place of Birth: Federal Medical Centre Bayelsa
8. State of Origin: BAYELSA
9. Home Town: Igbogene Epie
10. LGA of Origin: Yenagoa
11. Nationality: Yenagoa
12. Religion: CHRISTIAN
Section B: Extra-Curricular Activities
Indicate area(s) of Competence:
(Swimming, football, basketball, track and field, table/lawn tennis, etc)

Section C: Contact Address

1. Permanent Home Address: Okaka Estate
2. Hostel Name/Room No. (if any):
3. Off Campus Address:
4. Phone Number(s): 08126970329
5. Email Address: joemmy20@gmail.com

Section D: Next of Kin

1. Surname: Joel
2. First Name: Omovie
3. Middle Name(s): Winston
4. Relationship: Brother
5. Permanent Home Address: Okaka Estate
6. Phone Number(s): 08169498572
7. Email Address: joelisivie@gmail.com
Section E: Academic Details
1. Matric Number: 10990239GI
2. Faculty: BASIC MEDICAL SCIENCES
3. Department: HUMAN PHYSIOLOGY
4. Course of Study: HUMAN PHYSIOLOGY
5. Year of Study: 100

Section F: Primary Schools Attended

No Name of School From To
1 IJBCOE Nursery and primary school 2009 2015
2
3
4
5

Section G: Secondary/Technical Schools Attended

No Name of School From To
1 FGC Odi 2015 2021
2
3
4
5

Section H: JAMB Examination Particulars

1. Examination Center: Otuoke
2. Examination Date: 2021-02-20
3. JAMB Reg. Number: 10990239GI
No JAMB Subjects Score
1 ENGLISH LANGUAGE 50
2 BIOLOGY 51
3 CHEMISTRY 54
4 PHYSICS 37
Section I: Details of Secondary Schools Certificates
Exam Particulars 1st Sitting 2nd Sitting (if applicable)
Examination Name WAEC
Examination Centre FGC,ODI
Examination Date 2021-08-02
Examination Number 4070308072

Subjects Grades Subjects Grades

MATHEMATICS C5
ENGLISH LANGUAGE C4
PHYSICS C5
CHEMISTRY C5
BIOLOGY B3
PHYSICAL EDUCATION A1
COMPUTER STUDIES C5
CATERING D7
CIVIC EDUCATION C5
I, JOEL ISIVIE EMMANUEL, hereby certify that the information supplied in this
data form is correct; that I shall be held liable for any false information and shall accept the
consequences that follows.

Student's Signature Date