Application Form
Particulars of Candidate.
Application Number: NNR35/2023/CRO/4134/0137321
National Identification Number: 86199343654
Bank Verification Number: 22543187323
Department: Marine Engineering Artificer
Exam Centre: Abia
Center Location: NNFLS OWERRINTA
Title: MR Surname: MOSHE
First Name: GABRIEL Other Name: Afufu
Religion: christianity Marital Status: Single
Gender: Male Date Of Birth: 8/24/1998
State of Origin: CROSS RIVER LGA of Origin: Ogoja
Home Town: Ogoja Mobile Number: 09015766312
Height(Meters): 1.80 No. of Children: 0
Hobbies: Swimming, reading and Football Email:
gabrielmoshe3@[Link]
Permanent Address Igodor Nkum Ogoja Cross River State
Contact Address Igodor Nkum Ogoja Cross River State
Application Form
Next of Kin's Information
Full Name: IGBAJI CONFIDENCE Relationship: BROTHER
Occupation: STUDENT Mobile Number: 09067707035
Email: Post:
Contact Address: Igodor Nkum Ogoja Cross River State
Parent's / Guardian's Information
Full Name: MRS REGINA IGBAJI
Residential Address: Igodor Nkum Ogoja Cross River State
Referees
Referee Name Referee Address Referee Phone
Mrs. Regina Igbaji IGODOR NKUM OGOJA CROSS RIVER STATE 08029916714
Mr. Emiri Emmanuel Moshe MFOM II, EKAJUK, OGOJA CROSS RIVER STATE 08064996440
Education Information
Primary Details
School Qualification From To
Government Primary School, Ogboja, FIRST SCHOOL LEAVING CERTIFICATE 2008 2014
Ogoja (FSLC)
Secondary Details
School Qualification From To
Government Technical College, SENIOR SCHOOL CERTIFICATE 2014 2020
Abakpa, Ogoja EXAMINATION (SSCE)
Tertiary Details
Institution Course of Study Type From To Classification
Application Form
SSCE / NECO / WASSCE / GCE
No. of sittings: Exam Number 1:
Subject Grade Examination
Geography C6 CREDIT 10055036
Chemistry C5 CREDIT 10055036
Physics C5 CREDIT 10055036
Economics C4 CREDIT 10055036
Agricultural Science C4 CREDIT 10055036
Information & Communication Technology C5 CREDIT 10055036
Biology C4 CREDIT 10055036
English C6 CREDIT 10055036
Mathematics C4 CREDIT 10055036
Application Form
Have you taken Covid19 Vaccine? No
Have you ever served in the Armed Forces or any other security agency?No
Give details (if Yes):
Reason for leaving:
Have you suffered any mental illness before? No
Give details (if Yes):
Do you have any disability? No
Give details (if Yes):
Have you ever been convicted by a Court of Law? No
State reason (if Yes):
Conviction:
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: NNR35/2023/CRO/4134/0137321
I MOSHE GABRIEL, hereby declare that the information given in this application is true and that if
found to be false I should be prosecuted.
Signature: _______________________________ Date: _______________________________
Application Form
Consent by Parent/Guardian
Application Number: NNR35/2023/CRO/4134/0137321
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: NNR35/2023/CRO/4134/0137321
Title: MR Surname: MOSHE
First Name GABRIEL Other Name Afufu
Religion christianity Marital Status Single
Date Of Birth: Monday, August 24, 1998 Gender Male
State of Origin: CROSS RIVER LGA of Origin: Ogoja
Home Town Ogoja Mobile Number 09015766312
Height(Meters) 1.80 Email:
gabrielmoshe3@[Link]
Permanent Address Igodor Nkum Ogoja Cross River State
Certification by LGA Chairman / Secretary Or Senior Military Officer 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: NNR35/2023/CRO/4134/0137321
Title: MR Surname: MOSHE
First Name GABRIEL Other Name Afufu
Religion christianity Marital Status Single
Date Of Birth: Monday, August 24, 1998 Gender Male
State of Origin: CROSS RIVER LGA of Origin: Ogoja
Home Town Ogoja Mobile Number 09015766312
Height(Meters) 1.80 Email:
gabrielmoshe3@[Link]
Permanent Address Igodor Nkum Ogoja Cross River State
Certification by Divisional Police Officer
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 briefly
____________________________________________________________________________________________________________
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: NNR35/2023/CRO/4134/0137321
Title: MR Surname: MOSHE
First Name GABRIEL Other Name Afufu
Religion christianity Marital Status Single
Date Of Birth: Monday, August 24, 1998 Gender Male
State of Origin: CROSS RIVER LGA of Origin: Ogoja
Home Town Ogoja Mobile Number 09015766312
Height(Meters) 1.80 Email:
gabrielmoshe3@[Link]
Permanent Address Igodor Nkum Ogoja Cross River State
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/Office Address: _________________________________________________________________
Residential Address: ___________________________________________________________________________
Contact Address: ______________________________________________________________________________
Name: ______________________________________
Address: __________________________________________________________________________
Signature:__________________________________________
Date:________________________________________
This form is to be filled by a Military Officer not below the rank of Lt Col or equivalent/Police Officer 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 confirm the above given
information about you, will lead to automatic disqualification of the candidate.
Application Form
FOR OFFICIAL USE ONLY
Application Number: NNR35/2023/CRO/4134/0137321
Applicant's Full Name: MOSHE GABRIEL
Date Received:_____________________________________
Education Qualification: Number Of Credits/Passes obtained (SSCE / GCE / WASCE / NECO):_______
Documents Attached
a)_____________________________________________________
b)_____________________________________________________
c)_____________________________________________________
d)_____________________________________________________
e)_____________________________________________________
Detailed Result
Medical fitness:_____________________________________________________
General aptitude test score:_____________________________________________________
Vocational aptitude test score:_____________________________________________________
Remark
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Rank:_____________________________________________________
Name:_____________________________________________________
Signature and Date:_____________________________________________________
Director, DRRR
Rank:_____________________________________________________
Name:_____________________________________________________
Signature and Date:_____________________________________________________
