Application Form
Application Number National Identification Number Bank Verification Number
NNR37/2024/PLA/2886/0082756 14628128598 22623664922
Category Exam State Exam Center
Health Technicians - F2 Kaduna NAF BASE KADUNA
Title Surname First Name
Mr DORO DABWAN
Other Name Height Religion
PAM 1.99 Christianity
Marital Status Gender Date Of Birth
Single M Tuesday, July 4, 2000
State of Origin LGA of Origin Mobile Number
Plateau Riyom 08088655077
Home Town Permanent Address
Jos Jol village of Riyom
Parent/ Guardian Detail
Full Name Contact Address
Pam Doro Jol village
Next Of Kin
Full Name Relationship Mobile Number
Nehemiah Dauda Brother 08163620322
Occupation Contact Address
Student Rahol kak Gyel Along Shalom Primary School Bukuru
Application Form
Referee Details
Referee Name Phone Referee Address
Gyang Doro 09042111271 Jol village
Pam Doro 08138844514 Jol village
Primary Details
School Qualification From To
Dabwan Pam Doro fslc 2005 2012
Secondary Details
School Qualification From To
Victory Secondary School neco 2014 2019
SSCE / NECO / WASSCE / GCE
Subject Grade Examination
Mathematics C5 CREDIT 0140246
English C5 CREDIT 0140246
Physics C5 CREDIT 0140246
Chemistry C6 CREDIT 0140246
Biology C5 CREDIT 0140246
Tertiary Details
Course of
Institution Study Type From To Grade
Plateau State College of Health Technology Public Health ond 2021 2024 pass
Zawan
Application Form
APPLICANT'S DECLARATION
Application Number
NNR37/2024/PLA/2886/0082756
Application Number: NNR37/2024/PLA/2886/0082756
I DORO DABWAN , hereby declare that the information given in this application is true and that if found to be false I
should be prosecuted.
Signature: _______________________________ Date: _______________________________
Certification 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
NNR37/2024/PLA/2886/0082756
Title Surname First Name
Mr DORO DABWAN
Other Name Height Religion
PAM 1.99 Christianity
Marital Status Gender Date Of Birth
Single M Tuesday, July 4, 2000
State of Origin LGA of Origin Mobile Number
Plateau Riyom 08088655077
Home Town Permanent Address
Jos Jol village of Riyom
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
NNR37/2024/PLA/2886/0082756
Title Surname First Name
Mr DORO DABWAN
Other Name Height Religion
PAM 1.99 Christianity
Marital Status Gender Date Of Birth
Single M Tuesday, July 4, 2000
State of Origin LGA of Origin Mobile Number
Plateau Riyom 08088655077
Home Town Permanent Address
Jos Jol village of Riyom
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:_________________________________________
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:_______________________________