Application Form

Particulars of Candidate.

Application Number: NNR35/2023/CRO/4134/0137321

National Identification Number: 86199343654

Bank Verification Number: 22543187323

Department: Marine Engineering Artificer

Exam Centre: Abia

Center Location: NNFLS OWERRINTA

Title: MR Surname: MOSHE

First Name: GABRIEL Other Name: Afufu

Religion: christianity Marital Status: Single

Gender: Male Date Of Birth: 8/24/1998

State of Origin: CROSS RIVER LGA of Origin: Ogoja

Home Town: Ogoja Mobile Number: 09015766312

Height(Meters): 1.80 No. of Children: 0

Hobbies: Swimming, reading and Football Email:

 gabrielmoshe3@gmail.com

Permanent Address Igodor Nkum Ogoja Cross River State

Contact Address Igodor Nkum Ogoja Cross River State

 Application Form

Next of Kin's Information

Full Name: IGBAJI CONFIDENCE Relationship: BROTHER

Occupation: STUDENT Mobile Number: 09067707035

Email: Post:

Contact Address: Igodor Nkum Ogoja Cross River State

Parent's / Guardian's Information

Full Name: MRS REGINA IGBAJI

Residential Address: Igodor Nkum Ogoja Cross River State

Referees

Referee Name Referee Address Referee Phone

Mrs. Regina Igbaji IGODOR NKUM OGOJA CROSS RIVER STATE 08029916714

Mr. Emiri Emmanuel Moshe MFOM II, EKAJUK, OGOJA CROSS RIVER STATE 08064996440
Education Information

Primary Details

School Qualification From To

Government Primary School, Ogboja, FIRST SCHOOL LEAVING CERTIFICATE 2008 2014
Ogoja (FSLC)

Secondary Details

School Qualification From To

Government Technical College, SENIOR SCHOOL CERTIFICATE 2014 2020

Abakpa, Ogoja EXAMINATION (SSCE)

Tertiary Details

Institution Course of Study Type From To Classification

 Application Form

SSCE / NECO / WASSCE / GCE

No. of sittings: Exam Number 1:

Subject Grade Examination

Geography C6 CREDIT 10055036

Chemistry C5 CREDIT 10055036

Physics C5 CREDIT 10055036

Economics C4 CREDIT 10055036

Agricultural Science C4 CREDIT 10055036

Information & Communication Technology C5 CREDIT 10055036

Biology C4 CREDIT 10055036

English C6 CREDIT 10055036

Mathematics C4 CREDIT 10055036

 Application Form

Have you taken Covid19 Vaccine? No

Have you ever served in the Armed Forces or any other security agency?No
Give details (if Yes):
 
 
Reason for leaving:
 
 
Have you suffered any mental illness before? No
Give details (if Yes):
 
Do you have any disability? No
Give details (if Yes):
 
 
Have you ever been convicted by a Court of Law? No
State reason (if Yes):
 
Conviction:
 
 
Do you have any relative(s) serving or that served in the Armed Forces?

Full Name: Force:

Last Rank: Still in service?:

Full Name: Force:

Last Rank: Still in service?:

 Application Form
APPLICANT'S DECLARATION

Application Number: NNR35/2023/CRO/4134/0137321

I MOSHE GABRIEL, hereby declare that the information given in this application is true and that if
found to be false I should be prosecuted.

Signature: _______________________________ Date: _______________________________

 Application Form
Consent by Parent/Guardian

Application Number: NNR35/2023/CRO/4134/0137321

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: NNR35/2023/CRO/4134/0137321

Title: MR Surname: MOSHE

First Name GABRIEL Other Name Afufu

Religion christianity Marital Status Single

Date Of Birth: Monday, August 24, 1998 Gender Male

State of Origin: CROSS RIVER LGA of Origin: Ogoja

Home Town Ogoja Mobile Number 09015766312

Height(Meters) 1.80 Email:

gabrielmoshe3@gmail.com

Permanent Address Igodor Nkum Ogoja Cross River State

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: NNR35/2023/CRO/4134/0137321

Title: MR Surname: MOSHE

First Name GABRIEL Other Name Afufu

Religion christianity Marital Status Single

Date Of Birth: Monday, August 24, 1998 Gender Male

State of Origin: CROSS RIVER LGA of Origin: Ogoja

Home Town Ogoja Mobile Number 09015766312

Height(Meters) 1.80 Email:

gabrielmoshe3@gmail.com

Permanent Address Igodor Nkum Ogoja Cross River State

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 FORM

Application Number: NNR35/2023/CRO/4134/0137321

Title: MR Surname: MOSHE

First Name GABRIEL Other Name Afufu

Religion christianity Marital Status Single

Date Of Birth: Monday, August 24, 1998 Gender Male

State of Origin: CROSS RIVER LGA of Origin: Ogoja

Home Town Ogoja Mobile Number 09015766312

Height(Meters) 1.80 Email:

gabrielmoshe3@gmail.com

Permanent Address Igodor Nkum Ogoja Cross River State

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: NNR35/2023/CRO/4134/0137321

Applicant's Full Name: MOSHE GABRIEL
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, DRRR
Rank:_____________________________________________________
Name:_____________________________________________________
Signature and Date:_____________________________________________________