General Info * Name: Middle Name * Surname: National Identity Number * Date Of Birth (dd/mm/yyyy) * Sex Male Female Marital Status Single Married Divorced * Address * Email: Alternative Email: * Mobile Number: Alternative Number: RESIDENTIAL DETAILS * Address * Country * State Post Code * Country of Origin * State of Origin * LGA of Origin * Community Of Origin ACADEMIC REFEREE DETAILS * Academic Referee * Occupation * Address * Mobile Number * Email OTHER DETAILS * Are you on any scholarship/bursary Yes No * Do you have any physical disability? Yes No If Yes, State * Number of siblings * Parents Occupation Parents Marital Status Married Separated One Deceased Both Deceased NEXT OF KIN DETAILS * Next of kin * Address * Relationship * Mobile number Next JAMB DETAILS * Jamb Registration Number * Jamb Score * Course Intended (e.g Medicine, Engineering) * Preferred first choice of University Second Choice * Jamb Subject 1 * Jamb Subject 2 * Jamb Subject 3 * Jamb Subject 4 SECONDARY LEVEL (Please provide details of your secondary school status and institutions attended) * Name of Institution * Entry Year * Exit Year * 'O' level certificate obtained * Subject 1 * Grade Select Grade A1 B2 B3 C4 C5 C6 D7 E8 F9 * Subject 2 * Grade Select Grade A1 B2 B3 C4 C5 C6 D7 E8 F9 * Subject 3 * Grade Select Grade A1 B2 B3 C4 C5 C6 D7 E8 F9 * Subject 4 Grade Select Grade A1 B2 B3 C4 C5 C6 D7 E8 F9 * Subject 5 * Grade Select Grade A1 B2 B3 C4 C5 C6 D7 E8 F9 * Subject 6 * Grade Select Grade A1 B2 B3 C4 C5 C6 D7 E8 F9 * Subject 7 * Grade Select Grade A1 B2 B3 C4 C5 C6 D7 E8 F9 * Subject 8 * Grade Select Grade A1 B2 B3 C4 C5 C6 D7 E8 F9 Next Back PRIMARY LEVEL * Name of Primary School * Entry year * Exit Year * Certificate Obtained Next Back BANK DETAILS (Provide your bank details) * Bank * Account Name * Account Number * BVN * Why Do You Think You Are Eligible For a Scholarship Award? * How did you get to know about POTAF? Next Back DOCUMENTS * Waec Certificate Birth certificate/declaration of age * Local Government Identification Jamb UTME Result National Identification (optional) Passports submit Thank you for contacting us. Your application has been received. We will contact you in due course. Please turn on javascript to submit your data. Thank you! Recent Posts 2024 Academic Year One year Anniversary/Award Presentation Ceremony Official Launch/ Maiden Scholarship Award for the Professor Tam Adikibi Foundation (POTAF)
