NICA DITTE Application Form 2024-2025
NICA DITTE Application Form 2024-2025
NICA DITTE Application Form 2024-2025
Page 1 of 3
5. (a) Marital Status: ........................ (b) No. of children (if any)....... (c) Religious Affiliation …………………….
6. Next of Kin
Name: ….................................................... Tel No: ..….......................... Email: .…...............................................
4. Employment Record (Where applicable). Two years work experience in the relevant field is an added
advantage.
S/N INSTITUTION/ORGANIZATION RESPONSIBILITY FROM TO
Please attach relevant documents to confirm No. 4 e.g. appointment letter, letter of assignments etc.
Page 2 of 3
C. SPONSORSHIP:
Name(s) of Sponsor (if self-sponsored, write “SELF”)
........................................................................................................................................................................................
Address: .........................................................................................................................................................................
Tel No: ................................................................................ Email: .............................................................................
D. DECLARATION:
I declare that all the information given on this form is correct.
Signature of applicant: ................................................................................................ Date: ........................................
Page 3 of 3