GEON

EU

O R

NNPC/BELEMAOIL JV 2018/2019 SCHOLARSHIP APPLICATION FORMPOST GRADUATE

Please ensure forms are filled in capital “(a)” letter boldly and all required documents are duly attached.

APPLICANT INFORMATION:

NAME:SURNAME FIRST NAME MIDDLE NAME

SEX: Date of Birth:

PHONE: EMAIL:

STATE: LGA: COMMUNITY:

ADDRESS:

EDUCATION INFORMATION:

CURRENT INSTITUTION :

YEAR OF ENTRY: PROJECTED GRADUATION DATE:

COURSE:

MODE OF ADMISSION: DURATION OF PROGRAMME:

PREVIOUS INSTITUTION:

COURSE:

YEAR OF ADMISSION: CGPA: GRADUATION YEAR

ACCOUNT DETAILS:

BANK NAME: ACCOUNT NUMBER:

ACCOUNT NAME:

SORT CODE:

Are you related to any Belemaoil Producing Ltd Staff (Yes/No)?

If yes, State the name of the staff and nature of relationship:

Community Representative:(CDC INTERFACE CHAIRMAN) NAME SIGNATURE/DATE

STUDENT SIGNATURE:

2 recent passport photograph

GEON

EU

O R

NNPC/BELEMAOIL JV 2018/2019 SCHOLARSHIP APPLICATION FORMPOST GRADUATE

ASSEMBLE AND ATTACH TO THIS APPLICATION THE FOLLOWING DOCUMENTS:

1. Scholarship Application Form (Properly Filled with Passport Photograph at the top)2. University Post-Graduate Admission Letter3. Previous University Certificate/Statement of Result4. Transcript (where applicable)5. O’ Level Result6. Local Government Identification Letter7. Letter of Identification (Signed by either Traditional Ruler, or Community Representative (CDC

Chairman)

NOTE: Belemaoil does not demand any form of payment from applicants. The application is entirely free of charge.

FOR OFFICIAL USE ONLY:

Applicants Form Reviewed

Documents Completed

Documents Verified

Applicant Form Approved

Applicant Form Not Approved

Reason for Non-Approval:

Name & Signature of Reviewing Officer

Mangers Signature