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Registration Form

Personal and Contact Information
Institution:*

PERSONAL INFORMATION

Title:*
First Name:*
Middle Name:
Gender:*
Date of Birth:*
Place of Birth:*
Marital Status:*
Maiden Name:
Mother's Maiden Name:*
Spouse Name:
No of Children:
Nationality:*
State of Origin:*
LGA of Origin:*
Home Town
Religion *
National ID:
Drivers License:
International Passport Number:
Blood Group

CONTACT INFORMATION

Contact Address:*
Town:*
State:*
LGA:*
Permanent Home Address:*
Town:*
State:*
LGA:*
Mobile Phone No:*
Home Phone No
Email Address *




Employment Information

EMPLOYMENT INFORMATION

Block/ Office Room No
Office Telephone
Date of Employment:*
Date of Present Appointment:*
Confirmation Date into Civil Service
(Leave blank if not yet Confirmed):
Faculty/Schools:*
Department:*
units:*
Staff Location:*
Year of Deployment (YYYY):*   (e.g 2005)
Cadre:*
Payment Structure*
Grade Level:*
Step:*
Payroll Structure In June 2004:
Grade In June 2004:
Step In June 2004:
Trade Union :
Co-operative Societies :
No Cooperative Society has been attached to the selected Ministry
Federal Civil Service No:*
Establishment No:*
Incremental Date:*
Employment Type:*
Contract Appointment Exit Date :
 *Only for Contract Staff


Immediate Supervisor

Surname:*
Other Names:*
Post:*

ACCOUNT INFORMATION

Bank Type:*
Bank Name:*
Bank Account Name:*
Bank Branch:*
NUBAN Account Number:*
Type Of Account:*
Pension Fund Administrator (PFA):
Pension Identification No(PIN): PEN
Tax id:



Relatives and Emergency Information

NEXT OF KIN

Full Name:*
Address:*
City:*
State:*   choose 'OTHERS' if the person is outside nigeria
LGA:*
Relationship:*
Phone No:*
E-mail:*

EMERGENCY CONTACT

Fullname:*
Relationship:*
Address:*
City:*
State:*
LGA:*
Phone No:



Dependants Information

DEPENDANTS

Note: Maximum number of dependants allowed is 4
Surname Other Name Gender Date of Birth Relationship

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Educational Details

EDUCATION - Please Start From Earliest

Institution Attended: Institution Type: Qual.Type: Course Studied: Grade Obtained Year of Graduation
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COURSE

Course Attended Course Organiser's Name Start Date Number of Days Venue
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Promotions

PROMOTIONS- Please Start from when you joined the Federal Public Service- If Any

Old Job Post Old Grade Level Old Step
Notional Promotion Date Effective Promotion Date New Job Post New Grade Level New Step

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Transfer

WHEN YOU JOINED THE PUBLIC SERVICE

Supervising Ministry Agency/Parastatal/Board Department Division
Unit Section Town Job Post

TRANSFERS/MOVEMENTS/POSTINGS SINCE JOINING THE PUBLIC SERVICE - Please Start from the date you joined the Public Service

Effective Start Date Supervising Ministry Agency/Parstatal/Board Department
Unit Section Transfer Type End Date

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Employment History

COMPLETE EMPLOYMENT HISTORY

Employer Date Joined Last Position Held Exit Date Exit Mode

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