OPTIMISTIC BARRY WHITE LAND AND PROPERTIES INVESTORS

UTME 2024 REGISTRATION

A ESSENTIAL INFORMATION
(MUST AGREE WITH NIMC) YES NO PROFILE CODE:
PIN_________________________
Surname:________________________________First Name:____________________________________________________
Middle Name:____________________________Date of Birth______________________Sex:_________________________
Marital Status:________________Maiden Name if Married___________________Previous Name____________________

Mobile Number:

Nationality:___________________State of Origin______________________L.G.A:__________________________________

B OTHER INFORMATION
Disability/Challenge Blind Deaf Albino Lame Other None
Contact Address:______________________________________________________________________________________
Preferred State of Exam:___________Exam Town:_____________Interested in Jamb Mock Exam: Yes No

C CHOICE OF INSTITUTION
Candidate are to NOTE that their !st choice can also be a college of Education, University, Innovation Enterprise Institute,
Polytechnic/Monotechnic, NDA (Nigeria Defense Academy ) or Nigeria Police Academy.
1St Choice (Degree/ND/NCE):_____________________________________________________________________________
Programme of Study:___________________________________________________________________________________
2nd Choice (Institution):__________________________________________________________________________________
Programme of Study:___________________________________________________________________________________
3rd Choice (Institution):__________________________________________________________________________________
Programme of Study:___________________________________________________________________________________
Programme of Study:___________________________________________________________________________________
4th Choice (Institution):__________________________________________________________________________________
Programme of Study:___________________________________________________________________________________
D UTME SUBJECT

1 ENGLISH 3
2 4
E O’LEVEL INFORMATION
NAME SECONDARY SCHOOL ATTENDED:__________________________________________________________________

S/N O’LEVEL GRADE WAEC/NECO/NABTEB PUBLIC/PRIVATE YEAR EXAM NOS

SUBJECT

I_______________________________________Supplied the avove information. Signature & Date:___________________

FOR STAFF ONLY

Processed by:________________________________________________________Signature &Date___________________

Remark:____________________________________________________________

SPONSOR BY ADEDYANJU VICTOR B. A.K.A