UBEC Smart School - Application Form

APPLICANT TYPE

PRIMARY APPLICANT (ECCDE - Age 5+ by Sept 2024)

JUNIOR APPLICANT (Age 12+ by Sept 2024)

Please select the appropriate applicant type above. All fields must be filled in CAPITAL LETTERS.

SECTION A: BIO DATA

FULL NAME (SURNAME FIRST)

GENDER

MALE

FEMALE

DATE OF BIRTH

LOCAL GOVERNMENT AREA

STATE OF ORIGIN

PARENT/GUARDIAN FULL NAME

PARENT/GUARDIAN OCCUPATION

PARENT/GUARDIAN PHONE NUMBER

+234

Enter 10-digit phone number without 0

PARENT/GUARDIAN EMAIL ADDRESS

SECTION B: ACADEMIC BACKGROUND

PRESENT SCHOOL

CURRENT CLASS

DATE OF APPLICATION

SECTION C: MEDICAL HISTORY

HEALTH STATUS

DISABILITY (IF ANY)

NONE

PHYSICAL DISABILITY

HEARING IMPAIRMENT

VISUAL IMPAIRMENT

OTHER (SPECIFY)

SECTION D: ADMISSION REQUIREMENTS

THE CHILD MUST HAVE ATTAINED THE AGE OF 5 YEARS FOR ECCDE AS OF SEPTEMBER 2024

BIRTH CERTIFICATE/DECLARATION OF AGE
Upload a clear scanned copy
Uploaded
LOCAL GOVERNMENT INDIGEN CERTIFICATE
Upload a clear scanned copy
Uploaded
CERTIFIED MEDICAL REPORT
From a recognized government hospital
Uploaded
IMMUNIZATION/VACCINATION CARD
Upload a clear scanned copy
Uploaded
PRIMARY SCHOOL LEAVING CERTIFICATE
For junior applicants only
Uploaded

I DECLARE THAT ALL INFORMATION PROVIDED IN THIS FORM IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT PROVIDING FALSE INFORMATION MAY LEAD TO DISQUALIFICATION.