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HASKE BUSINESS SCHOOL

NEW STUDENT REGISTRATION FORM

SECTION A: BIO DATA

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Name :

Other Name(S):

Title:

Gender
Marital Status

SECTION B: CONTACT DETAILS

TO BE FILLED BY NIGERIAN NATIONALS

State of Origin:

L.G.A:

State of Residence:

Place of Residence:

Home Address:

Mobile Number:

Phone (include code):

Email Address:

Name of Next Kin:

Address of Next Kin:

Phone Number of Next Kin:

TO BE FILLED BY NON-NIGERIAN NATIONALS

Country of Origin:

Country of Residence:

Home Address:

Pastcode/Zip:

Mobile Number:

Email Address:

Name of Next Kin:

Address of Next Kin:

Phone Number of Next Kin:

SECTION C: EDUCATIONAL QUALIFICATIONS

SCHOOLS ATTENDED WITH DATES

 I. Name of  School attended:

From:

To:

 II. Name of  School attended:

From:

To:

ORDINARY AND ADVANCED LEVEL RESULTS

DETAILS(ORDINARY LEVEL)

l.Subject:

Grade:

Exam Body:

ll.Subject:

Grade:

Exam Body:

lll.Subject:

Grade:

Exam Body:

lV.Subject:

Grade:

Exam Body:

V.Subject:

Grade:

Exam Body:

DETAILS (ADVANCE LEVEL)

l.Subject:

Grade:

Exam Body:

ll.Subject:

Grade:

Exam Body:

lll.Subject:

Grade:

Exam Body:

TERTIARY EDUCATION RESULTS

DETAILS OF TERTIARY INSTITUTION

l. Institution  Name:

Specialization/Discipline:

Result type:

Class of result:

Year of graduation:

ll. Institution  Name:

Specialization/Discipline:

Result type:

Class of result:

Year of graduation:

SECTION D: COURSE REGISTRATION

FIRST SEMESTER

l. Code:

Course:

Credit Unit:

Registration Officer Signature:

ll. Code:

Course:

Credit Unit:

Registration Officer Signature:

Total Units:

SECOND SEMESTER

Course:

Credit Unit:

l. Code:

Registration Officer Signature:

ll. Code:

Course:

Credit Unit:

Registration Officer Signature:

Total Units:

Total Fees Paid (Words):

Total Fees Paid (Figure):

Balance of Fees not Paid (Figure):