Application Form

Particulars of Candidate.

Application Number: DSSC25/2017/KWA/56/0001361

Exam Centre: Fct Location: Command Day Secondary School, Mogadishu Barracks.

Department: EDUCATION Specialisation Geography

Title: MR Surname: ABDULWAHAB

First Name: ABDULRASHEED Other Name: ABIODUN

Religion: Islam Marital Status: Single

Gender: Male Date Of Birth: 3/18/1992

State of Origin: KWARA LGA of Origin: Ilorin East

Home Town: IPONRIN Mobile Number: 08106954617

Height(Meters): 1.78 No. of Children:

Hobbies: READING AND PHYSICAL TRAINING Email: rashrock18@gmail.com

Tattoo/Body Marks: No Tribal Marks: No

Permanent Address NO. 6 KAJE CLOSE ALONG MURTALA MUHAMMED WAY, KABALA WEST, KADUNA.

Contact Address
 Application Form

Next of Kin's Information

Full Name: ABDULWAHAB ABDULFATAI OPEYEMI Relationship: BROTHER

Occupation: MARITIME ACADEMY STUDENT Mobile Number: 08183670272

Email: abdulwahababuamar@gmail.com Post: CADET

Contact Address: NO. 6 KAJE CLOSE ALONG MURTALA MUHAMMED WAY, KABALA WEST, KADUNA.

Parent's / Guardian's Information

Full Name: ABDULWAHAB

Residential Address: NO. 6 KAJE CLOSE ALONG MURTALA MUHAMMED WAY, KABALA WEST, KADUNA.

Referees

Referee Name Referee Address Referee

Phone

ALAHAJI (Dr) SULEIMAN KOREDE. A 18 IBRAHIM TAIWO ROAD, P.O BOX 8239, 08028433195
FICEN, NAE, GAMA, MIICA TUDUN WADA, KADUNA.

GROUP CAPTAIN BAMIDELE FLYING TRAINING SCHOOL (FTS), NIGERIAN 08033283636

OLRUNNISOLA ADEBAYO AIRFORCE BASE, KADUNA.
Education Information

Primary Details

School Quali cation From To

BLESSED ACADEMY, NURSERY AND PRIMARY PRIMARY SCHOOL LEAVING 1999 2004
SCHOOL, KADUNA. CERTIFICATE

Secondary Details

School Quali cation From To

BLESSED ACADEMY, SECONDARY JUNIOR SECONDARY CERTIFICATE 2004 2007

SCHOOL, KADUNA EXAMINATION (JSCE)

ANNY SECONDARY SCHOOL, RIGASA, SECONDARY SCHOOL LEAVING 2007 2009

KADUNA. CERTIFICATE

Tertiary Details

Institution Course of Type From To Classi cation

Study

AHMADU BELLO UNIVERSITY, ZARIA, GEOGRAPHY Degree 2011 2015 Second Class
NIGERIA. Upper
 Application Form

SSCE / NECO / WASSCE / GCE

No. of sittings: 1 Exam Number 1: 4190405022

Subject Grade

AGRICULTURAL SCIENCE C6 CREDIT

BIOLOGY C6 CREDIT

CHEMISTRY C6 CREDIT

ECONOMICS B3 GOOD

ENGLISH LANGUAGE C6 CREDIT

GEOGRAPHY B3 GOOD

MATHEMATICS C5 CREDIT
 Application Form

Have you ever served in the Armed Forces or any other security agency?No
Give details (if Yes):
Reason for leaving::
Do you have any Job Experience Yes
Give details (if Yes):
Reason for leaving::
Have you ever been detained by the Police? No
State reason (if Yes):
Duration of detention:
Have you ever been convicted by a Court of Law? No
State reason (if Yes):
Conviction:
Have you ever travelled out of the country? No
Travel details:
Do you have any relative(s) serving or that served in the Armed Forces?

Full Name: Force:

Last Rank: Still in service?:

Full Name: Force:

Last Rank: Still in service?:

 Application Form
APPLICANT'S DECLARATION

Application Number: DSSC25/2017/KWA/56/0001361

I ABDULWAHAB ABDULRASHEED, hereby declare that the information given in this application is true
and that if found to be false I should be prosecuted.

Signature: _______________________________ Date: _______________________________

Certi cation by Parents / Guardian

I _____________________________________ parent/guardian of ______________________________________, who is applying

for recruitment into the Nigerian Navy, hereby certify that I fully understand that my child/ward will (if
required to) attend the Recruitment Exercise and I shall not demand compensation or relief from the
Government in respect of death or any injury which my child/ward may sustain in the course of or as a
result of any task given to him/her during the exercise.

Parent / Guardian Witness

Name: _________________________________ Name: _________________________________

Address: _______________________________ Address: _______________________________

Signature: _______________________________ Signature: _______________________________

Date:_______________________________ Date:_______________________________
 Application Form
LOCAL GOVERNMENT AREA CERTIFICATION

Application Number: DSSC25/2017/KWA/56/0001361

Title: MR Surname: ABDULWAHAB

First Name ABDULRASHEED Other Name ABIODUN

Religion Islam Marital Status Single

Date Of Birth: Wednesday, March 18, 1992 Gender Male

State of Origin: KWARA LGA of Origin: Ilorin East

Home Town IPONRIN Mobile Number 08106954617

Height(Meters) 1.78 Email: rashrock18@gmail.com

Permanent Address NO. 6 KAJE CLOSE ALONG MURTALA MUHAMMED WAY, KABALA WEST, KADUNA.

Certi cation by LGA Chairman / Secretary Or Senior Military O cer not below the rank of
Commander or equivalent Or Chief Superintendent Of Police from Applicant's State of Origin

I certify that the applicant ___________________________________ is an indigene of _______________________ L.G.A,

________________ State, and that to the best of my knowledge and belief, the facts stated on the form are
correct. I hereby declare that if any statement made in connection with this application is proven to be
false I should be prosecuted.

Name:_________________________________________

Address:_________________________________________________________________

Signature:_________________________________________

Date:_________________________________________
 Application Form
POLICE CERTIFICATION

Application Number: DSSC25/2017/KWA/56/0001361

Title: MR Surname: ABDULWAHAB

First Name ABDULRASHEED Other Name ABIODUN

Religion Islam Marital Status Single

Date Of Birth: Wednesday, March 18, 1992 Gender Male

State of Origin: KWARA LGA of Origin: Ilorin East

Home Town IPONRIN Mobile Number 08106954617

Height(Meters) 1.78 Email: rashrock18@gmail.com

Permanent Address NO. 6 KAJE CLOSE ALONG MURTALA MUHAMMED WAY, KABALA WEST, KADUNA.

Certi cation by Divisional Police O cer

I certify that the applicant _________________________________ is an indigene of ______________________Town,

_________________________ L.G.A, ________________ State and that his/her parent hails from
__________________________ L.G.A. of _________________ State. That he/she has no criminal record on him/her. (If
any state brie y
________________________________________________________________________________________________________________________
That to the best of my knowledge and belief the facts stated in the form are correct and I hereby declare that
if any statement made in connection with this application is proven to be false I should be prosecuted.

Name:_______________________________

Address:_______________________________

Signature:_______________________________

Date:_______________________________
 GUARANTOR'S FORM

Application Number: DSSC25/2017/KWA/56/0001361

Title: MR Surname: ABDULWAHAB

First Name ABDULRASHEED Other Name ABIODUN

Religion Islam Marital Status Single

Date Of Birth: Wednesday, March 18, 1992 Gender Male

State of Origin: KWARA LGA of Origin: Ilorin East

Home Town IPONRIN Mobile Number 08106954617

Height(Meters) 1.78 Email: rashrock18@gmail.com

Permanent Address NO. 6 KAJE CLOSE ALONG MURTALA MUHAMMED WAY, KABALA WEST, KADUNA.

Particulars of Guarantor

Surname: ______________________________________ First Name: ____________________________________

Middle Name: _________________________________ Town: _________________________________________
LGA: __________________________________________ State of Origin: ________________________________
Mobile: ________________________________________ E-mail: ________________________________________
Appointment: __________________________________How long have you known the candidate:_______
Formation/Unit/O ce Address: _________________________________________________________________
Residential Address: ___________________________________________________________________________
Contact Address: ______________________________________________________________________________
Name: ______________________________________
Address: __________________________________________________________________________
Signature:__________________________________________
Date:________________________________________
This form is to be lled by a Military O cer not below the rank of Lt Col or equivalent/Police O cer not
below the rank of Chief Superintendent of Police/Assistant Director at either Federal or State Civil
Service certifying the eligibility of the applicant. You need not to come from an applicant’s State of Origin to
guarantee him/her only be sure of the character. Please note that inability to con rm the above given
information about you, will lead to automatic disquali cation of the candidate.
 Application Form
FOR OFFICIAL USE ONLY

Application Number: DSSC25/2017/KWA/56/0001361

Applicant's Full Name: ABDULWAHAB ABDULRASHEED
Date Received:_____________________________________
Education Quali cation: Number Of Credits/Passes obtained (SSCE / GCE / WASCE / NECO):_______
Documents Attached
a)_____________________________________________________
b)_____________________________________________________
c)_____________________________________________________
d)_____________________________________________________
e)_____________________________________________________
Detailed Result
Medical tness:_____________________________________________________
General aptitude test score:_____________________________________________________
Vocational aptitude test score:_____________________________________________________
Remark
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
 
Rank:_____________________________________________________
Name:_____________________________________________________
Signature and Date:_____________________________________________________
Director, DRRR
Rank:_____________________________________________________
Name:_____________________________________________________
Signature and Date:_____________________________________________________

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