| 
   
        
Post Jamb Registration Form 
2015/2016 Academic Session 
Enter the following
      details below and click submit.  | 
| Jamb
      Number | 
 | 
| Surname | 
 | 
| Other
      names | 
 | 
| Sex | 
 | 
| Date of Birth | 
 | 
| Local Government Area | 
 | 
| State Of
      Origin | 
 | 
| Phone | 
 | 
| Email | 
 | 
|   | 
  | 
| Institution of first Choice | 
 | 
| 
      Institution of Second Choice | 
 | 
|   | 
  | 
| Course of First Choice   (Pick
      from list) | 
 | 
| Course of
      Second Choice (Pick from
      list) | 
 | 
|   | 
  | 
| Jamb
      Aggregate Score | 
 | 
| Note:Please ensure that the information you have filled
      into this form is true and accurate |