Application Form
Application Number National Identification Number Bank Verification Number
NNR37/2024/NAS/2146/0067372 60768382018 22432764325
Category Exam State Exam Center
Store Assistant - E2 Enugu HQ 82 DIV
Title Surname First Name
Mr John Elijah
Other Name Height Religion
1.72 Christianity
Marital Status Gender Date Of Birth
Single M Saturday, December 25, 2004
State of Origin LGA of Origin Mobile Number
Nasarawa Kokona 09052661602
Home Town Permanent Address
Angwan mayo, nasarawa state Angwan mayo, nasarawa state
Parent/ Guardian Detail
Full Name Contact Address
John Ezekiel Ajegena Angwan mayo, nasarawa state
Next Of Kin
Full Name Relationship Mobile Number
John ovey Brother 08116667043
Occupation Contact Address
Civil servant Ojo, lagos state
Application Form
Referee Details
Referee Name Phone Referee Address
Sergeant Ode 07081579500 Navy base onitcha
Gaius john 09033499490 Army headquarter lagos
Primary Details
School Qualification From To
Pilot primary school angwan mayo, nasarawa state fslc 2006 2011
Secondary Details
School Qualification From To
Pilot primary school angwan mayo, nasarawa state waec 2011 2016
SSCE / NECO / WASSCE / GCE
Subject Grade Examination
Mathematics C6 CREDIT 4191043141
English C6 CREDIT 4191043141
Economics C4 CREDIT 4191043141
Financial Accounting A1 EXCELLENT 4191043141
Commerce C4 CREDIT 4191043141
Tertiary Details
Institution Course of Study Type From To Grade
Nasarawa state polytechnic Accounting ond 2017 2018 pass
Application Form
APPLICANT'S DECLARATION
Application Number
NNR37/2024/NAS/2146/0067372
Application Number: NNR37/2024/NAS/2146/0067372
I John Elijah , 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/NAS/2146/0067372
Title Surname First Name
Mr John Elijah
Other Name Height Religion
1.72 Christianity
Marital Status Gender Date Of Birth
Single M Saturday, December 25, 2004
State of Origin LGA of Origin Mobile Number
Nasarawa Kokona 09052661602
Home Town Permanent Address
Angwan mayo, nasarawa state Angwan mayo, nasarawa 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
NNR37/2024/NAS/2146/0067372
Title Surname First Name
Mr John Elijah
Other Name Height Religion
1.72 Christianity
Marital Status Gender Date Of Birth
Single M Saturday, December 25, 2004
State of Origin LGA of Origin Mobile Number
Nasarawa Kokona 09052661602
Home Town Permanent Address
Angwan mayo, nasarawa state Angwan mayo, nasarawa 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:_________________________________________
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 Certification
Application Number
NNR37/2024/NAS/2146/0067372
Title Surname First Name
Mr John Elijah
Other Name Height Religion
1.72 Christianity
Marital Status Gender Date Of Birth
Single M Saturday, December 25, 2004
State of Origin LGA of Origin Mobile Number
Nasarawa Kokona 09052661602
Home Town Permanent Address
Angwan mayo, nasarawa state Angwan mayo, nasarawa 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: NNR37/2024/NAS/2146/0067372
Applicant's Full Name: John Elijah
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
Rank:_____________________________________________________
Name:_____________________________________________________
Signature and Date:_____________________________________________________