You are on page 1of 7

Application Form

Application Number National Identification Number Bank Verification Number


NNR36/2024/OYO/2346/0140033 53232526757 22534176411

Category Exam State Exam Center


Nurses Kwara NNSHS OFFA

Title Surname First Name


Mr James Enoch

Other Name Height Religion


Oluwafemi 1.68 Christianity

Marital Status Gender Date Of Birth


Single M Sunday, June 25, 2000

State of Origin LGA of Origin Mobile Number


Oyo Saki West 09034096491

Home Town Permanent Address


Saki Imua Saki west Oyo state Nigeria

Parent/ Guardian Detail

Full Name Contact Address


James Usman Jamesusman23@gmail.com

Next Of Kin

Full Name Relationship Mobile Number


James Jeremiah Brother 0813 429 6265

Occupation Contact Address


Student Imua Saki west Oyo state Nigeria
Application Form
Referee Details

Referee Name Phone Referee Address

Ojo Olusegun 0813 944 5437 Ganbe road oke oyi ilorin east kwara state Nigeria

James Mathew 0903 217 4348 Imua Saki west Oyo state Nigeria

Primary Details
School Qualification From To

Africa Baptist School Imua fslc 2004 2009

Secondary Details

School Qualification From To

Africa Baptist School Imua neco 2011 2017

SSCE / NECO / WASSCE / GCE

Subject Grade Examination

Mathematics C6 CREDIT 73724484DB

English C5 CREDIT 73724484DB

Physics C5 CREDIT 73724484DB

Chemistry C6 CREDIT 73724484DB

Biology C6 CREDIT 73724484DB

Tertiary Details

Institution Course of Study Type From To Grade

Bartholomew college of Community health ond 2019 2022 upper_credit


health technology Extension Workers
Application Form
APPLICANT'S DECLARATION

Application Number
NNR36/2024/OYO/2346/0140033

Application Number: NNR36/2024/OYO/2346/0140033


I James Enoch, 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/OYO/2346/0140033

Title Surname First Name


Mr James Enoch

Other Name Height Religion


Oluwafemi 1.68 Christianity

Marital Status Gender Date Of Birth


Single M Sunday, June 25, 2000

State of Origin LGA of Origin Mobile Number


Oyo Saki West 09034096491

Home Town Permanent Address


Saki Imua Saki west Oyo state Nigeria

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/OYO/2346/0140033

Title Surname First Name


Mr James Enoch

Other Name Height Religion


Oluwafemi 1.68 Christianity

Marital Status Gender Date Of Birth


Single M Sunday, June 25, 2000

State of Origin LGA of Origin Mobile Number


Oyo Saki West 09034096491

Home Town Permanent Address


Saki Imua Saki west Oyo state Nigeria

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/OYO/2346/0140033

Title Surname First Name


Mr James Enoch

Other Name Height Religion


Oluwafemi 1.68 Christianity

Marital Status Gender Date Of Birth


Single M Sunday, June 25, 2000

State of Origin LGA of Origin Mobile Number


Oyo Saki West 09034096491

Home Town Permanent Address


Saki Imua Saki west Oyo state Nigeria

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 Officer not below the rank of Lt Col or equivalent/Police Officer 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/OYO/2346/0140033


Applicant's Full Name: James Enoch
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:_____________________________________________________

You might also like