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Secondary School Students Registration Form
Surname*
First name*
Othernames*
Date of Birth
Country
Sex*
State*
Local Govt Area
Religion
Address
Name of Parent/Guardian
Occupation
Phone Number
Email Address
Primary/Secondary School Attended
Last Class Admitted
Class Applying For
Is the child suffering from physical or mental illness?
Any Disability?
NO
YES
Any recurrent ill health
Any Disability?
NO
YES
Reason for Changing School
Other Information About the Child
Submit