Application Form

Application Number
NNR37/2024/KEB/4790/0175077
National Identi cation Number
66525435049
Bank Veri cation Number
22800419619

Category
Firemen - D7
Exam State
Lagos
Exam Center
NNS OJO

Title
Mr
Surname
Isah
First Name
Abdulrahaman

Other Name
-
Height
1.69
Religion
Islam

Marital Status
Single
Gender
M
Date Of Birth
Tuesday, February 10, 2004

State of Origin
Kebbi
LGA of Origin
Zuru
Mobile Number
09077071650

Home Town
Zuru
Permanent Address
Waje Area zuru kebbi state

Parent/ Guardian Detail

Full Name
Isah musa
Contact Address
Waje Area zuru kebbi state

Next Of Kin

Full Name
Shamsudeen Isah
Relationship
Brother
Mobile Number
07018367181

Occupation
Student
Contact Address
Waje Area zuru kebbi state
 Application Form
Referee Details

Referee Name Phone Referee Address

Ibrahim Umar 07018367181 Waje Area zuru kebbi state

Nana Abbakar 09044788342 Waje Area zuru kebbi state

Primary Details
School Quali cation From To

Waje nizamiya primary school fslc 2012 2018

Secondary Details

School Quali cation From To

Government Day Secondary School Chonoko waec 2018 2024

SSCE / NECO / WASSCE / GCE

Subject Grade Examination

Mathematics A1 EXCELLENT 4222201042

English C6 CREDIT 4222201042

Biology B3 GOOD 4222201042

Government A1 EXCELLENT 4222201042

Economics B3 GOOD 4222201042

Hausa C4 CREDIT 4222201042

Civic Education A1 EXCELLENT 4222201042

Islamic Studies A1 EXCELLENT 4222201042

Animal Husbandry C5 CREDIT 4222201042

Tertiary Details

Institution Course of Study Type From To Grade

 Application Form
APPLICANT'S DECLARATION

Application Number
NNR37/2024/KEB/4790/0175077

Application Number: NNR37/2024/KEB/4790/0175077

I Isah Abdulrahaman, hereby declare that the information given in this application is true and that if found to be false
I should be prosecuted.

Signature: _______________________________ Date: _______________________________

Certi cation 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/KEB/4790/0175077

Title
Mr
Surname
Isah
First Name
Abdulrahaman

Other Name
-
Height
1.69
Religion
Islam

Marital Status
Single
Gender
M
Date Of Birth
Tuesday, February 10, 2004

State of Origin
Kebbi
LGA of Origin
Zuru
Mobile Number
09077071650

Home Town
Zuru
Permanent Address
Waje Area zuru kebbi state

Certi cation by LGA Chairman / Secretary Or Senior Military O cer 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/KEB/4790/0175077

Title
Mr
Surname
Isah
First Name
Abdulrahaman

Other Name
-
Height
1.69
Religion
Islam

Marital Status
Single
Gender
M
Date Of Birth
Tuesday, February 10, 2004

State of Origin
Kebbi
LGA of Origin
Zuru
Mobile Number
09077071650

Home Town
Zuru
Permanent Address
Waje Area zuru kebbi state

Certi cation by LGA Chairman / Secretary Or Senior Military O cer 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:_________________________________________
Certi cation by Divisional Police O cer
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 brie y
___________________________________________________________________________________________________________________________________
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 Certi cation

Application Number
NNR37/2024/KEB/4790/0175077

Title
Mr
Surname
Isah
First Name
Abdulrahaman

Other Name
-
Height
1.69
Religion
Islam

Marital Status
Single
Gender
M
Date Of Birth
Tuesday, February 10, 2004

State of Origin
Kebbi
LGA of Origin
Zuru
Mobile Number
09077071650

Home Town
Zuru
Permanent Address
Waje Area zuru kebbi 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/O ce Address: _________________________________________________________________
Residential Address: ___________________________________________________________________________
Contact Address: ______________________________________________________________________________
Name: ______________________________________
Address: __________________________________________________________________________
Signature:__________________________________________
Date:________________________________________

This form is to be lled by a Military O cer not below the rank of Lt Col or equivalent/Police O cer 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 con rm the above given information about you, will lead to
automatic disquali cation of the candidate.
 Application Form
FOR OFFICIAL USE ONLY

Application Number: NNR37/2024/KEB/4790/0175077

Applicant's Full Name: Isah Abdulrahaman
Date Received:_____________________________________
Education Quali cation: Number Of Credits/Passes obtained (SSCE / GCE / WASCE / NECO):_______
Documents Attached
a)_____________________________________________________
b)_____________________________________________________
c)_____________________________________________________
d)_____________________________________________________
e)_____________________________________________________
Detailed Result
Medical tness:_____________________________________________________
General aptitude test score:_____________________________________________________
Vocational aptitude test score:_____________________________________________________
Remark
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________

Rank:_____________________________________________________
Name:_____________________________________________________
Signature and Date:_____________________________________________________
Director
Rank:_____________________________________________________
Name:_____________________________________________________
Signature and Date:_____________________________________________________