P.M.B.

13 Auchi, Edo State

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Application No.: COE/ND2324/14879 | Jamb Reg. No.: 202330294443GA
Application Form 2023/2024
JAMB PHOTO
FOR 2023/2024***: Admissions (Regular)

Course of Study Information

Proposed Programme of Study:
Proposed Course of Study:
Department:
Application Number:
ND
COMPUTER ENGINEERING TECH.
COMPUTER ENGINEERING TECH.
COE/ND2324/14879
This Passport will remain your valid passport while in
Auchipolytechnic

Personal & Contact Detail

Surname LAWANI
Other Names SHEDRACK EMISHO
Maiden Names (For Female only)
Date of Birth 10 April,2006
Sex Male
Marital Status Single
Nationality NIGERIA
State EDO STATE
L.G.A AKOKO EDO LOCAL GOVT AREA
Edo State L.G.A. Akoko Edo
Permanent Home Address MOMODU AJAYI ROAD, IGARRA, EDO STATE
Present Postal Address MOMODU AJAYI ROAD, IGARRA, EDO STATE
Name & Address of Parents/Guardian MR. AND MRS LAWANI
Occupation of Parents/Guardin BUSINESS
Parent Phone Number 0703647632

Educational Qualification
Grade
S/N Subject Examination Center No. Exam No. Exam Date Year of Exam.
Obtained

1. Marketing WAEC/SSCE/GCE 4130106 126 May/June 2022 C4

2. Geograhy A1
3. English Language A3
4. Mathematics A1
5. Agriculture C4
6. Biology A3
 7. Chemistry A2
8. Physics A2

Number of Certificates
One
Combined:

Other Certificates Obtained (for HND and Post-HND applicants)

Certificate Subject Area Grade Year of Graduation Matric Number GPA

Jamb Exam Details (Required for all Applicants)

Jamb Registration Number 202330294443GA
Year Examination was taken 2023
Jamb Exam Center ZIMKON
Jamb Exam Result 194
Subject 1 Score ENGLISH 47
Subject 2 Score Mathematics 59
Subject 3 Score Physics 46
Subject 4 Score CHEMISTRY 42
Total Jamb Score 194
First Choice of School Chosen in
AUCHI POLYTECHNIC AUCHI
JAMB
First Choice of Course Chosen in
COMPUTER ENGINEERING TECH.
JAMB
Second Choice of School Chosen in
AUCHI POLYTECHNIC AUCHI
JAMB
Second Choice of Course Chosen in
COMPUTER ENGINEERING TECH.
JAMB

Other Information
Reason for choice of Course: MY FIELD OF STUDY
Have you been a student in a similar institution before? If so, give the name of the institution, the period of attendance,
the course of study and reason for leaving. : NILL
Who will be responsible for your fees? :MY PARENTS
Have you been convicted? If yes, state nature of offence :NILL

References:
Name Address Phone/Email
MOMODU AJAYI ROAD, IGARRA, EDO
MR AND MRS LAWANI 0703647632
STATE

I hereby declare that the Information given here is to the best of my knowkedge true and correct

Signature: ......................................................................................
Date:..........................................................................