New Student Panel

Personal Information

Title

Surname

Other Names

Phone Number

Jamb Registration Number

Date of Birth

College

Department

Programme

Level

Degree

Ever matriculated in other Institution?

If yes Where?

Matriculation No in the Institution

Course Studied There

State Reason(s) for leaving:

Sex
Male Female

Marrital Status

Religion:

Nationality

State of Origin

Home Town or Village

Local Government Area

Permanent Home Address

Postal Address

E-mail Address

Parent/Guardian/Sponsor Information

Name

Address

Phone Number

Occupation

Mother's Name

Mother' s Occupation

Next of Kin Information

Name of Next of Kin

Relationship with Next of Kin

Type of Sponsorship

Type of Adimission into MTU:

Section B (FOR FOREIGN STUDENTS ONLY)

Passport No:

Date Issued:

Where Issued:

Passport Valued:

Visa Residence Permit Valid Till:

Section C (FOR COUNSELLING UNIT)

Type of Family:

No of Children:

Position in the Family:

Are your Parent living together:

if no, why are they separated?:

Who is responsible for your school fees:

Name of Activity/Fellowship:

Post Held:

Remarks:

Name of Sports:

Achievement(Team, Prize,Medals):

Special Medical Treament being received:

Where:

What is your life ambition:

Personal effort(s) made to achieve it :

Section D (ACADEMIC DATA)

Primary School Attended:

From:

To:

Scondary School Attended:

From:

To:

Tetiary Institution Attended (if any):

From:

To:

Please Upload a Passport in gif or jpeg format and saved it as your Jamb Number. Maximum size of File is 50kb.

Passport:

Please Upload your O Level Result in gif or jpeg or pdf format and saved it as your Jamb Number. Maximum size of File is 50kb.

Result: