AFE BABALOLA UNIVERSITY ADO-EKITI P.M.B 5454 Ado-Ekiti,Ekiti State,
Nigeria. ADMISSION ELIGIBILITY FORM APPLICATION FORM FOR 2025/2026 ACADEMIC SESSION FORM NO: 00778
IMPORTANT NOTICE:
PASSPORT
PLEASE, COMPLETE ALL ENTRIES LEGIBLY IN CAPITAL LETTERS.
SECTION A: PERSONAL DETAILS Name of Candidate: ………………………………………………………………………………………………………….. Contact address: ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………………………………………. Telephone No: ……………………………………… Email: ………………………………………………………………. Date of Birth (dd/mm/yyyy): ……………………………………..........Sex: Male
Female Nationality:
……………………………..L.G.A:………………………………...State Of Origin:………………………….. Religion:………………………………………………… Denomination:………………………………………………… Marital status:……………………………………… Maiden name:………………………………………………….
PARENT/GUARDIAN DETAILS Name: …………………………………………………………………………………………………………………………… Contact address:…………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………. Email address:………………………………………………………………………………………………………………. Relationship:……………………………………………… Phone No: ………………………………………………. Occupation:…………………………………………………………………………………………………………………
SPONSOR’S DETAILS Name: …………………………………………………………………………………………………………………………… Contact address: …………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………. Email address: ………………………………………………………………………………………………………………. Relationship: ……………………………………………… Phone No: ………………………………………………. Occupation: …………………………………………………………………………………………………………………
FOR OFFICIAL USE ONLY
APPLICATION REQUIREMENT
Date Application Form was Issued:
Passport Photographs (2)
Receipt No.:
Photocopies of Results
Date:
Application Fee Paid:
Date:
Officer Signature/Date: Date:
_ Exam No.:
Birth Certificate/Age Declaration Local Government of Origin
SECTION B: EDUCATION PURSUIT Programme: DEGREE:
FOUNDATION:
JAMB Registration Number:
UTME SUBJECTS 1
SCORES
Use of English
2 3 4 TOTAL UTME SCORE DIRECT ENTRY: FIRST CHOICE OF STUDY: SECOND CHOICE OF STUDY:
SECTION C: ACADEMICS RECORDS NAME AND LOCATION OF INSTITUTION
FROM
PERIOD
TO
QUALIFICATION OBTAINED (e.g.) SSCE, B.SC, MBBS
EXAMINATION TAKEN WITH RESULT WAEC/SSCE SUBJECT
GRADE
NECO SUBJECT
GRADE
A LEVEL/OTHERS SUBJECT GRADE
GCE O’ LEVEL SUBJECT GRADE
EXAM DATE
EXAM DATE
EXAM DATE
EXAM DATE
CENTRE
CENTRE
CENTRE
CENTRE
EXAM NO
EXAM NO
EXAM NO
EXAM NO
SECTION D: DECLARATION I solemnly declare that all the information provided by me above is correct and true. I, therefore, accept responsibility for any inaccuracies and/or falsification which Afe Babalola University Ado-Ekiti management may discover and consider grave enough to lead to the termination of my studentship at any time during my stay in the Afe Babalola University Ado-Ekiti or even to the withdrawal of any certificate awarded based on the information. I also promise to abide by all rules and regulations.
Full Name
Signature
Date
COUNTER-SIGNED BY PARENTS/GUARDIANS I,…………………………………………………………………………………… certify that I am the..........................(State relationship) to........................................................................(Candidate full name) .I confirm that the information given in SECTION A AND B above by the candidate and also endorse the declaration by him/her in SECTION C.
Full Name
Signature
Date
FOR OFFICIAL USE ONLY NAME OF COORDINATOR: COMMENT:
DATE OF REGISTRATION:
SIGNATURE: