Adesoye College Offa - Nigeria: Quest for Excellence

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	Application Form 2009/2010
	ADESOYE COLLEGE, OFFA Application for Admission into Class One 2009/2010 Name ................................................................................................................ Surname First Names (Underline the one used daily) Date of Birth ........................................................... Sex ............................. Age on 1st September 2009................ Present Class.......................................... Present School........................................................................................................ Present School Address.............................................................................................................................. State of Origin................................................................ L G A ............................................................... Town....................................................................................................................................................... Father's Name ........................................................................................................................................ Father's Occupation ................................................................................................................................ Mother's Name ....................................................................................................................................... Mother's Occupation ............................................................................................................................... Parent's Postal Address .......................................................................................................................... .............................................................................................................................................................. .............................................................................................................................................................. Residential Address (if different from above)................................................................................................ ............................................................................................................................................................... .............................................................................................................................................................. Telephone Nos: (Home) ....................................... mobile:........................................................................ (Office) ........................................ mobile: .......................................................................... (e_mail) .......................................................................................................................... Examination Centre Preferred (OFFA, ABUJA, P.H., KADUNA or OVERSEAS) ................................................................ Parent's Signature.............................................................................. Date..................................... NOTE: Please attach copies of Primary 4,5,6 reports and photostat copy of Birth Certificate. Originals must be produced on the day of the exam. HAVE YOU ENCLOSED A STAMPED SELF-ADDRESSED ENVELOPE? (See previous page) ---------------------------------------------------------------------------------------------- OVERSEAS CANDIDATES GUARDIANS' PARTICULARS (must visit the school in person) Guardian's Name................................................................................................................................. Guardian's Relationship to Candidate..................................................................................................... Guardian's Postal Address.................................................................................................................... .......................................................................................................................................................... .......................................................................................................................................................... Guardian's Residential Address (if different from above)............................................................................ .......................................................................................................................................................... .......................................................................................................................................................... Telephone Nos: (Home) .................................. Mobile: ........................................................................ (Office) .................................. Mobile: ......................................................................... (e_mail) .......................................................................................................................

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