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2018 UTME REGISTRATION FORM SAMPLE TEMPLATE

Section 1:

Surname (Family Name):

Middle Name: Attach Recent

Passport Here.
First Name: Photo should not
be older than 3
Date of Birth: Sex:
months
Day / Month / Year Male / Female

Disabilities: Marital Status:

Blind / Deaf / Physical Handicap / None Single / Married / Divorce

Postal Address:

Address Town: State & Country:

Email: Mobile Number:

Nationality: State of Origin: L.G.A:

Preferred State of Exam: Exam Town:

Candidates are to note that their 1 choice can also be a College of Education, University, Innovation Enterprise
Institutes, Polytechnics/Monotechnics, NDA (Nigerian Defence Academy) or Nigeria Police Academy.

st
1 Most Preferred Institution:
(University)
Course:

nd
2 Most Preferred Institution:
(University/Poly/COE)
Course:

rd
3 Most Preferred Institution:
(Poly/COE)
Course:

th
4 Most Preferred Institution:
(COE/IEI)
Course:
 Uploaded online by Nigerianscholars.com

2018 UTME REGISTRATION FORM SAMPLE TEMPLATE

Section 2:

Would you like to take the OPTIONAL UTME MOCK-EXAMINATION?

Yes /No

UTME Subjects
O’Level Type (e.g. WAEC, NECO, NABTEB, GCE London etc)
1: Use of English

2: O’Level Subjects Grades

3: 1:
2:
4:
3:
4:
NOTES: 5:
6:
7:
8:
All grades stated should be a Maximum
Number of 2 sittings