N S S E N R O L M E N T F O R M

PHOTO ON NATIONAL ID UPLOADED PHOTO

NSS Number : NSSGHS5814523

PIN: TCYGHS5162723

National ID New Voter's Id

ID Number 1931014786

PERSONAL INFORMATION
NAME ON NATIONAL ID : KYEREMAAH VERA

Surname: Kyeremaah Other Names : Vera

Name Of Institution: CATHOLIC UNIVERSITY COLLEGE Course Of Study: Registered General Nursing
OF GHANA

Sex: Female Date of Birth: 14-6-1996

Marital Status : Married Nationality : Ghana

Contact Tel No.(s) : +233243852779 Email Address : verakyeremaa18@gmail.com

Residential Address : Nkwabeng

Ghana GPS Digita Address : : Residential Region BONO

GUARDIAN INFORMATION
Guardian Name : Edmund Owusu-Ansah Frimpong

Guadian Email : Guadian Phone No +233243852779

NEXT OF KIN INFORMATION

Name of Next of Kin: Jayson Owusu-Ansah F Kin's Contact No. : +233243852779

Relationship: Son

EMPLOYMENT HISTORY & OTHER INFORMATION

Are you currently employed? No Study Leave Type:

The Organization you work

with(Your Study Leave
Sponsor):

Organization Phone #:

Do you have any health condition? No Health Condition Type:

Health Condition Details:

Do you have Military Training?* No Have you done Service Before*: No

Organization you have

served before:

POSTING PREFERENCES INFORMATION

Region I: BONO Region II: BONO EAST Region III: AHAFO

INDUSTRIAL PREFERENCE - SERVICE OPTION

Service Option Community Health Service Option Educational Support Entrepreneurship
I:: II: Type:
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