Jextoban Secondary School

…a value driven school

JEXTOBAN SECONDARY SCHOOL

APPLICATION FORM

1.0 Student Bio- Details Click here to enter text. Click here to enter text. Click here to enter text. Surname First Name Other Names Choose an item. Click here to enter a date. Gender Date of Birth (DD-MM-YY) Click here to enter text. Click here to enter text. Click here to enter text.

Nationality State of Origin Local Government Area Click here to enter text. Click here to enter text.

Present School & Address Current Class 2.0 Additional Student details Kindly Indicate your wards sporting skills, and other talents. Click here to enter text.

3.0 Campus preference for application Jextoban Lagos State Jextoban Ogun State DAY ☐ BOARDING☐ DAY ☐ BOARDING☐

4.0 Contact Details Click here to enter text. Title: Choose an item. Full name of Mother

Jextoban Secondary School 1/3 Ibadan Street Alapere Ketu Lagos state , KM 36 Lagos Ibadan Express way Ibafo Ogun state Tel: : +2348035530048, +2348167871888 Lagos, +2348160704632 +2348162769282 Ogun website www.jextoban.com E- mail [email protected], or info@jextoban,com [email protected] …a value driven school Click here to enter text. Full Address ( Residential) Click here to enter text. Click here to enter text. Click here to enter text. Occupation Nationality Country of residence ( ) Click here to enter text. Work Telephone e-mail address ( ) ( ) Mobile Telephone Home Telephone

Click here to enter text. Tile Choose an item. Full name of Father Click here to enter text. Full Address ( Residential) Click here to enter text. Click here to enter text. Click here to enter text. Occupation Nationality Country of residence ( ) Click here to enter text. Work Telephone e-mail address ( ) ( ) Mobile Telephone Home Telephone

5.0 Please indicate with whom the child is mainly resident Mother:☐ Father:☐ Both Parents:

6.0 Guardian If Child is not living with parents in Nigeria Click here to enter text. Title: Choose an item. Full name of Guardian Click here to enter text. Full Address ( Residential) Click here to enter text. Click here to enter text. Click here to enter text. Occupation Nationality Country of residence ( ) Click here to enter text. Work Telephone e-mail address ( ) Click here to enter text. Mobile Telephone Relationship to child

7.0 Medical Conditions Does the child suffer any Medical Health conditions YES ☐ NO☐

Jextoban Secondary School 1/3 Ibadan Street Alapere Ketu Lagos state , KM 36 Lagos Ibadan Express way Ibafo Ogun state Tel: : +2348035530048, +2348167871888 Lagos, +2348160704632 +2348162769282 Ogun website www.jextoban.com E- mail [email protected], or info@jextoban,com [email protected] …a value driven school If YES, Please Click here to enter text. specify :

8.0 Important Documents Please ensure the following documents are attached 1) A copy of Bank teller payment of N10,000.00 for Application form 2) Payment should be made to designated bank in favor of Jextoban Secondary School FMCB PLC Acct: 0337559014 3) Scanned copy of Child Birth Certificate 4) Two recent passport photographs of your child (passport must be not Less than 6 months old) 5) For Transfer students copy of child transcript.

9.0 Quick Survey How did you hear of Jextoban Secondary School? Primary School ☐ TV/Radio / ☐ Flyers/ Bill ☐ News paper Board Adverts Website ☐ Siblings ☐ Friend/Relative ☐ 10.0 Declaration This is to certify that the information provided on behalf of our child is correct, Furthermore the school has our consent to review such information provided including medical records in order to safeguard and promote the welfare of our child

Signature Signature Parent 2 Parent 1 /Guardian Date Date

Click here to Click here to enter text. enter text.

Full Name of Full Name of Parent 2 Parent 1 /Guardian 1

FOR OFFICAL PURPOSE

Jextoban Secondary School 1/3 Ibadan Street Alapere Ketu Lagos state , KM 36 Lagos Ibadan Express way Ibafo Ogun state Tel: : +2348035530048, +2348167871888 Lagos, +2348160704632 +2348162769282 Ogun website www.jextoban.com E- mail [email protected], or info@jextoban,com [email protected] …a value driven school

Jextoban Secondary School 1/3 Ibadan Street Alapere Ketu Lagos state , KM 36 Lagos Ibadan Express way Ibafo Ogun state Tel: : +2348035530048, +2348167871888 Lagos, +2348160704632 +2348162769282 Ogun website www.jextoban.com E- mail [email protected], or info@jextoban,com [email protected]