INSTITUTE OF MANAGEMENT AND TECHNOLOGY - Application

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BIO-DATA

Last name

First name

Middle name

Date Of Birth

Gender

Verification Code

Mobile number

Contact Address

Country

State Of Origin

Local Government Area (LGA)

Nationality (Non-Nigerians)

Disabilities (if any)

Hobbies

Next-of-Kin Name

Next-Of-Kin Address

PROGRAMME CHOICE

Programme Category*

Programme Type

FIRST CHOICE

SCHOOL

Department

Programme

SECOND CHOICE (ONLY FOR ND AND PRE-ND)

SCHOOL

Department

Programme

JAMB/MPCME DETAILS

JAMB/MPCME Reg number*

JAMB/MPCME Subj Offered(e.g. ENG/MTHS/BIO/CHE)*

JAMB/MPCME Score*

EDUCATIONAL HISTORY

School attended*

From*

To*

Qualification Obtained*

Kindly add school attended.

SCHOOL ATTENDED	FROM	TO	QUALIFICATION OBTAINED

NATIONAL DIPLOMA RESULT (THIS APPLIES TO HND APPLICANTS ONLY)

Kindly add school attended to the Educational History section.

ND Course Completed

Effective Date of Graduation (mm/yyyy)

CGPA (e.g. 3.65, 4.00)

Class of Qualification

ND Registration No.

ND Result Serial No. (IMT Graduates only)

AWARDING INSTITUTION (Select ND Awarding institution)

IMT STUDENTS ONLY OTHER INSTITUTIONS

POST ND-INDUSTRIAL EXPERIENCE (THIS APPLIES TO HND APPLICANTS ONLY)

Kindly add school attended to the Educational History section.

From

Name of Organisation

Address of Organisation

Duration (In months, e.g 6)

Describe Experience

O' LEVEL RESULTS

Select number of sittings

Kindly add Grades to the First sitting.

FIRST SITTING RESULT DETAILS

Year Taken*

Exam Period*

Exam Type*

Subject*

Grade*

SUBJECT	GRADE

Kindly add Grades to the Second sitting.

SECOND SITTING RESULT DETAILS

Year Taken*

Exam Period*

Exam Type*

Subject*

Grade*

SUBJECT	GRADE

PASSPORT UPLOAD

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Kindly review your application details below and note that they cannot be edited after submission.

BIO-DATA

First name:

Surname:

Middle name:

Date Of Birth:

Gender:

Email:

Mobile number:

Contact Address:

Country:

Nationality (Non-Nigerians):

State Of Origin:

Local Government Area (LGA):

Disabilities (if any):

Hobbies:

Next-Of-Kin Name:

Next-Of-Kin Address:

PROGRAMME CHOICE AND JAMB/MPCME DETAILS

Programme Category:

Programme Type:

SCHOOL (First Choice):

Department (First Choice):

Programme (First Choice):

(First Choice):

SCHOOL (Second Choice):

Department (Second Choice):

Programme (Second Choice):

(Second Choice):

JAMB/MPCME Reg number:

JAMB/MPCME Subj Offered:

JAMB/MPCME Score:

EDUCATIONAL HISTORY PREVIEW

SCHOOL ATTENDED	FROM	TO	QUALIFICATION OBTAINED

NATIONAL DIPLOMA RESULT

ND Course Completed:

Effective Date of Graduation (mm/yyyy):

CGPA:

Class of Qualification:

Awarding Institution:

ND Registration No.:

ND Result Serial No.:

POST ND-INDUSTRIAL EXPERIENCE

From:

Name of Organisation:

Address of Organisation:

Duration (In months, e.g 6):

Describe Experience:

O' LEVEL RESULTS

Number of sittings:

FIRST SITTING

Year Taken:

Exam Period:

Exam Type:

SUBJECT	GRADE

SECOND SITTING

Year Taken:

Exam Period:

Exam Type:

SUBJECT	GRADE

PASSPORT REVIEW

ATTESTATION AND HUMAN ENTRY VALIDATION

ATTESTATION: I agree that my studentship be withdrawn if it is found that I have given false information in my registration forms. I solemnly and sincerely promise and declare that I will pay due respect and obedience to the Rector and other officers of the Institution, and that I will faithfully observe all regulations which may from time to time be issued by them for the good order and governance of the Institution.

APPLICATION FORM