+234(0)9029 061 431 | admin@portal.peacepoly.com.ng

Fresh Students Registration

NOTE: All fields marked with (*) are compulsory!
First Name*:
Middle Name:
Last Name*:
Maiden Name (married women only):
Email*:
Phone*:
State of Origin*:
L.G.A*:
Date of Birth*:
Gender*:
Marital Status*:
Religion*:
Contact Address*:
Home Address*:
Name of last secondary school attended *:
Address of last secondary school attended *:
Certificate Obtained (WAEC, NECO, etc) *:
Number of Sittings*:
O'Level Results(Max 2 Sittings)*:
S/N Subject Grade
1
2
3
4
5
6
7
8
9
Programme Applied for *:
Department*:
Mode of Study *:
For Students Applying through JAMB
JAMB Reg. Number:
Parent/Guardian Data
Full Name*:
Email*:
Phone*:
Application PIN*:
PIN Serial Number*:
© 2019 | PIMT Portal