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Form 19

This document is a validity form for undergraduate admission at the Federal University of Technology, Owerri, requiring candidates to complete and return it with their acceptance letter within two weeks. It includes sections for personal information, course of study, accommodation preferences, and extracurricular activities. The form also contains a declaration for compliance with university regulations and sections for office use regarding admission details and payment status.

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pantherlord0508
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42 views2 pages

Form 19

This document is a validity form for undergraduate admission at the Federal University of Technology, Owerri, requiring candidates to complete and return it with their acceptance letter within two weeks. It includes sections for personal information, course of study, accommodation preferences, and extracurricular activities. The form also contains a declaration for compliance with university regulations and sections for office use regarding admission details and payment status.

Uploaded by

pantherlord0508
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Federal University of Technology, Owerri

VALIDITY FORM - UNDERGRADUATE


ADMISSION

Two copies of this form should be duly completed by all the candidates
admitted in this university and returned with the Letter of Acceptance for
Provisional Admission to THE REGISTRAR (ADMISSIONS) not later than two
weeks from date of issue.

1. COURSE OF STUDY

SCHOOL: ELECTRICAL SYSTEMS AND ENGINEERING TECHNOLOGY


DEPARTMENT: MECHATRONIC ENGINEERING
JAMB REG NO: 202440643575EF
MODE OF ADMISSION (TICK): MERIT SUPPLEMENTARY

2. PERSONAL INFORMATION

SURNAME: NGBARONYE
OTHERNAMES: NMESIRIONYE PAUL
HOME/PERMANENT ADDRESS: NDDC HOSTEL (MALE), 38, 38A
PHONE NUMBER: 07040379525
POSTAL ADDRESS: (IF DIFFERENT FROM ABOVE): ...................................................................................
DATE OF BIRTH: 2008-08-05
STATE: ABIA STATE
LGA: UMUAHIA NORTH
NATIONALITY: NIGERIA
NAME AND ADDRESS OF PARENT/GUARDIAN: NGBARONYE PEACE OSINACHI
PHONE NUMBER OF PARENT/GUARDIAN: 08037555912
EMAIL: peaceotuagbo@gmail.com
PERSON TO CONTACT IN CASE OF EMERGENCY: ...................................................................................

3. ACCOMODATION

INTEREST IN ON-CAMPUS RESIDENCE INTEREST IN OFF-CAMPUS RESIDENCE

4. EXTRA CURRICULAR ACTIVITIES

SPORTS (STATE THEM) .....................................................


DECLARATION

I am grateful to the vice chancellor for the admission and hereby undertake as a student of FUTO to observe and comply
with all ordinances and regulations of the University as fas they concern me.

Signature: .................................................... Date:......................................................................

FOR OFFICE USE ONLY

Year of Admission: ________________________________________________________________________________________

Acceptance/Dev Levy: Paid / UnPaid

Receipt No: ________________________________________________________________________________________

Verify By: ________________________________________________________________________________________

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