NIGERIAN NAVY 2ozs Ostch 34 Recrutment Exercise Application Form Particulars of Candidate. ‘Application Number: NNR34/2022/ADA/3907/0067964 National Identification Number: 83614741151 Bank Verification Number: 22341703198 Department: Store Assistant Exam Centre: Adamawa Center Location: 23 BDE YOLA Title: MR. First Name: ALIYU Religion: Islam Gender: Male State of Origin; ADAMAWA Home Town: TOUNGO Height(Meters): 1.85 Hobbies: READING FOOTBALL Permanent Address YERIMA ISA TOUNGO !I WARD Contact Address YERIMA ISA TOUNGO II WARD ‘Surname: ISA Other Name: Marital Status: Single Date Of Birth: 10/5/1999 LGA of Origin: Tounge Mobile Number: 08161772611 No. of Children: 0NIGERIAN NAVY 2033 Batch 34 Recruftment Exercise Application Form Next of Kin's Information Full Name: ZULAIHATU YAU Relationship: SISTER Occupation: STUDENT Mobile Number: 07063425057 Email: Post: Contact Address: YERIMA ISA TOUNGO II WARD Parent's / Guardian's Information Full Name: ISA WAZIRI Residential Address: YERIMA ISA TOUNGO I WARD Refer Referee Name Referee Address: Referee Phone AHMED ISA WAZIRI ‘YERIMA ISA TOUNGO II WARD 08067645514 ‘ALH. JAIMU MOHAMMED GABDO YERIMA ISA TOUNGO II WARD 08065640877NIGERIAN NAVY Batch 34 Recruftmant Exercise Education Information Primary Details School Qualification From To TOUNGO I PRIMARY SCHOOL FSLC 2003 2008, ‘Secondary Details ‘School Qualification From To GOVERNMENT SECONDARY SCHOOL, TOUNGO Neco 2008 2014 Tertiary Det Institution Course of Study Type From = To._——Classification‘SSCE / NECO / WASSCE / GCE No. of sittings: Subject Geography Government Economics Mathematics English Islamic Studies Civic Education NIGERIAN NAVY Application Form Exam Number 1: Grade C8 CREDIT 07 PASS 07 PASS ce cREDIT 8 OREDIT cs CREDIT £8 PASS Batch 34 Recruftmant Exercise Examination 40160057DH 40160057DH 40160057DH 401600570H 40160057DH 40160057DH 40160057DHNIGERIAN NAVY Batch 34 Recruftmant Exercise Application Form Have you taken Covid19 Vaccine? Yes Have you ever served in the Armed Forces or any other security agency?No Give details (if Yes): Reason for leaving Have you suffered any mental ilness before? No Give details (f Yes): Do you have any disability? No Give details (if Yes): Have you ever been convicted by a Court of Law? No State reason (if Yes): Conviction: Do you have any relative(s) serving or that served in the Armed Forces? Full Name: Force: Last Rank: ‘Still in service?: Full Name: Force: Last Rank: Still in service?:NIGERIAN NAVY 2oza Batch 34 Recruitment Exercise Application Form [APPLICANT'S DECLARATION ‘Application Number: NNR34/2022/ADA/3907/0067964 LISA ALIYU, hereby declare that the information given in this appl | should be prosecuted Signature: Date:NIGERIAN NAVY Batch 34 Recruftmant Exercise Application Form Consent by Parent/Guardian ‘Application Number: NNR34/2022/ADA/3907/0067964 ' parent/guardian of ‘who is applying for recruitmont into the Nigerian Navy, hereby ‘cortify that fully understand that my child/ward will (f 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 childiward may sustain in the course of or as a result of any task given to him/her during the exercise. Parent / Guardian Name: Name: Address: Address: Signature: Signature: Date: Date:NIGERIAN NAVY Application Form Batch 34 Recruftmant Exercise LOCAL GOVERNMENT AREA CERTIFICATION ‘Application Number: NNR34/2022/ADA/3907/0067961 Title: MR First Name ALIYU Religion Islam Date Of Birth: Tuesday, October 5, 1999, State of Origin: ADAMAWA Home Tewn TOUNGO Hoight(Motors) 1.85 Permanent Address YERIMA ISA TOUNGO Il WARD ‘Surname: ISA Other Namo Marital Status Single Gender Mate LGA of Origin: Toungo Mobile Number 08161772611 Email: [email protected] 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 | certify that the applicant is an indigene of ‘State, and that to the best of my knowledge and belief, the facts stated on the form are correct. [hereby declare that if any statement made in connection LGA, with this application is proven to be false I should be prosecuted. Name: Address: Signature: Date:NIGERIAN NAVY Batch 34 Recruftmant Exercise Application Form POLICE CERTIFICATION ‘Application Number: NNR34/2022/ADA/3907/0067964 Title: MR ‘Surname: ISA First Name ALIYU Other Namo Religion Islam Marital Status Single Date Of Birth: Tuesday, October 5, 1999, Gonder Mate State of Origin: ADAMAWA LGA of Origin: Toungo Home Town TOUNGO Mobile Number 08161772611 Hoight(Motors) 1.85 Email: [email protected] Permanent Address YERIMA ISA TOUNGO Il WARD Certification by Divisional Police Officer | cery that the applicant, is an indigene of ‘Town, LGA, ‘State and that his/her parent halls from LGA of State. That he/she has no criminal record on himiher. (IFany state briefly That to the best of my knowledge and belief the facts slated in the form are correct and | hereby declare that if any statement made in connection with this application is proven to be false | should be prosecuted Name: Address: Signature: Date:NIGERIAN NAVY Batch 34 Recruftmant Exercise GUARANTOR'S FORM ‘Application Number: NNR34/2022/ADA/3907/0067964 Title: MR. ‘Surname: ISA First Name ALIYU Other Name Marital Status Single Gender Male LGA of Origin: Tounge Home Town TOUNGO Mobile Number 08161772611 Helght(Meters) 1.85 Email: [email protected] Permanent Address YERIMA ISA TOUNGO II WARD Particulars of Guarantor ‘Sumame: First Name: Middle Name: Town: LGA State of Origin: Mobile E-mail Appointment How long have you known the candidate: Formation/UnivOffice Address: Residential Address: Contact Address: Name! Address: Signature: Date: This form is tobe filled by a Military Officer not below the rank of Lt Col or equivalentiPolice Officer not below the rank of Chief Superintendent of Police/Assistant Director at either Federal or State Civil Service cortifying the elighilty ofthe applicant. You need not to come from an applicant's State of Origin to guarantee hhimsher 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 Number: Applicant's Full Name: Date Received Education Qualification Documents Attached Remark NIGERIAN NAVY Batch 34 Recruftmant Exercise Application Form FOR OFFICIAL USE ONLY NNR34/2022/ADA/3907/0067961 ISAALIYU Number Of Credits/Passes obtained (SSCE / GCE / WASCE / NECO): a by eg gy ° Medical fitness: General aptitude test scare: Vocational aptitude test score: Director, DRRR Rank Name! Signature and Date: Rank: Name! Signature and Date: