Application Form
Application Number National Identification Number Bank Verification Number
NNR37/2024/KAT/993/0021240 78277061761 22791020593
Category Exam State Exam Center
Seaman Kastina 35 BN KATSINA
Title Surname First Name
Mr ADO MUHAMMED
Other Name Height Religion
1.71 Islam
Marital Status Gender Date Of Birth
Single M Thursday, January 1, 2004
State of Origin LGA of Origin Mobile Number
Katsina Kankara 07084949098
Home Town Permanent Address
Kankara DAN DUTSE KANKARA
Parent/ Guardian Detail
Full Name Contact Address
ABUBAKAR ABDU HARI Jobe Street Kankara VCM320
Next Of Kin
Full Name Relationship Mobile Number
ABUBAKAR ABDU HARI Brother 07063485422
Occupation Contact Address
CIVIL SERVANT VCM 320 JOBE STREET BEHIND PHC KANKARA
Application Form
Referee Details
Referee Name Phone Referee Address
BRIGADIER GENERAL H. MOHAMMED 08088740556 NIGERIAN ARMY HEADQUARTERS
ABUBAKAR ABDULRAMAN 08115418627 Katsina state ministry of education
Primary Details
School Qualification From To
Nuhu model primary school Kankara fslc 2012 2017
Secondary Details
School Qualification From To
UNCLE D MEMORIAL INTERNATIONAL SECONDARY SCHOOL, neco 2018 2023
KANKARA
SSCE / NECO / WASSCE / GCE
Subject Grade Examination
Mathematics B3 GOOD 2310101720AF
English C4 CREDIT 2310101720AF
Physics C4 CREDIT 2310101720AF
Chemistry C6 CREDIT 2310101720AF
Hausa A1 EXCELLENT 2310101720AF
Civic Education C5 CREDIT 2310101720AF
Islamic Studies C6 CREDIT 2310101720AF
Animal Husbandry B2 VERY GOOD 2310101720AF
Tertiary Details
Institution Course of Study Type From To Grade
Application Form
APPLICANT'S DECLARATION
Application Number
NNR37/2024/KAT/993/0021240
Application Number: NNR37/2024/KAT/993/0021240
I ADO MUHAMMED, 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
NNR37/2024/KAT/993/0021240
Title Surname First Name
Mr ADO MUHAMMED
Other Name Height Religion
1.71 Islam
Marital Status Gender Date Of Birth
Single M Thursday, January 1, 2004
State of Origin LGA of Origin Mobile Number
Katsina Kankara 07084949098
Home Town Permanent Address
Kankara DAN DUTSE KANKARA
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
NNR37/2024/KAT/993/0021240
Title Surname First Name
Mr ADO MUHAMMED
Other Name Height Religion
1.71 Islam
Marital Status Gender Date Of Birth
Single M Thursday, January 1, 2004
State of Origin LGA of Origin Mobile Number
Katsina Kankara 07084949098
Home Town Permanent Address
Kankara DAN DUTSE KANKARA
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 Certification
Application Number
NNR37/2024/KAT/993/0021240
Title Surname First Name
Mr ADO MUHAMMED
Other Name Height Religion
1.71 Islam
Marital Status Gender Date Of Birth
Single M Thursday, January 1, 2004
State of Origin LGA of Origin Mobile Number
Katsina Kankara 07084949098
Home Town Permanent Address
Kankara DAN DUTSE KANKARA
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: NNR37/2024/KAT/993/0021240
Applicant's Full Name: ADO MUHAMMED
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:_____________________________________________________
