Wesley University
APPLICATION FORM
Course Information
Please, TICK your application:
UNDERGRADUATE
CONVERSION
PART-TIME
POSTGRADUATE
Course of study details
College
*
Select College
AGRICULTURE, FOOD SCIENCE AND TECHNOLOGY
ARTS
NATURAL AND APPLIED SCIENCES
ENVIRONMENTAL DESIGN AND MANAGEMENT
SOCIAL AND MANAGEMENT SCIENCES
HEALTH SCIENCES
EDUCATION
LAW
PART TIME STUDIES
POST GRADUATE STUDIES
NON-TEACHING
Course
*
Select College first
Study Centre
*
Select Campus
Wesley University, Ondo.
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Personal Information
First Name
*
Last Name (Surname)
*
Other Name
Date of Birth
*
Gender
*
Select Gender
Male
Female
Marital Status
*
Select Marital Status
Single
Married
Divorced
Others
Maiden Name
*
Nationality
*
State of Origin
*
Local Government Area/Origin
*
Contact Address
*
Phone Number
*
Email Address
*
Whatsapp Number
Extra Curriculum Activities
*
Any health challenges, specify if you have any
Sponsor/Next of Kin name
*
Sponsor/Next of Kin contact address
*
Sponsor/Next of Kin phone number
*
Sponsor/Next of Kin E-Mail Address
*
Sponsor/Next of Kin Whatsapp Number
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Qualification Details
Details of UTME (if Applicable)
JAMB Registration Number
Aggregate Score
Subject Combination
Subject 1
Score
Subject 2
Score
Subject 3
Score
Subject 4
Score
Details of Direct Entry
Exam Type
DE JAMB Registration Number (if Applicable)
Score/Grade
Highest Qualification for DE
Details of WASC/NECO/NATEB(Maximum of two sittings)
Exam Type
Exam Number
First Sitting
Subject
Score
Second Sitting
Subject
Score
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Previous Education Details and other Degrees
Institution and contact
Course
Date
Grade
Institution and contact
Course
Date
Grade
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Employment Details (if applicable)
Employer's Company name and contact Address
Job Title
Date Commenced
Duration
Employer's Company name and contact Address
Job Title
Date Commenced
Duration
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Declaration
I,
certify that all the statements are correct: any false information would lead to disqualification.
Guarantor's Signature (Type name of guarantor. The electronic signature below and its related fields are treated by Wesley University like a physical handwritten signature on a paper form.)
Date
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