ONLINE REGISTRATION FORM

NIM - NYSC GRADUATE INDUCTION PROGRAMME
Examination Number:    
Teller Number:

Amount Paid:

Name of Bank:

Date of Payment: e.g. Year-Month-Day
(yyyy-mm-dd)

 
Title(e.g. Mr.):    
Surname (In full):    
Firstname (In full):    
Other names (In full):    
Gender:    
Current City:    
current Postal Address:    
State of Origin:    
Date of Birth: e.g. Year-Month-Day
(yyyy-mm-dd)
    
Telephone:

Mobile (GSM):

E-mail Address:    
 
Preferred Induction Venue: select your choice    
Preferred Chapter: select your choice    
Tuition Center e.g. Lagos (Ojota), Abuja (CBS), Ogun (Shagamu) etc.    
Profession e.g. Engineering, Law, Teaching etc.    
Institution Attended
NAME OF INSTITUTION:

QUALIFICATION OBTAINED:

YEAR:

Work Experience:
NAME OF ORGANIZATION:

ADDRESS OF ORGANIZATION:

POSITION HELD:

YEAR:

 
NOTE: Check carefully all the details / enteries you have entered above for correctness before clickng on the SUBMIT button below, this is because correction would not be possible afterwards

 
Very Important: P L E A S E, click on the SUBMIT DATA button only ONCE, and wait till the next page that diplays your records appears