Navy - Form

Application Form
Particulars of Candidate.
Application Number: NNR32/2020/OND/1083/0041605
National Identi cation Number: 99283856847
Department: Seaman
Exam Centre: Nasarawa
Center Location: 177 BN KEFFI
Title: MR Surname: OJOMO
First Name: DANIEL Other Name:
Religion: christianity Marital Status: Single
Gender: Male Date Of Birth: 7/14/2001
State of Origin: ONDO LGA of Origin: Okitipupa
Home Town: Mobile Number: 08106389742
Height(Meters): 1.65 No. of Children:
Hobbies: Cooking,music and reading Email: Ojomodnl@gmail.com
Tattoo/Body Marks: Tribal Marks:
Permanent Address Opposite sec school aso pada mararaba nasarawa state
Contact Address Opposite sec school aso pada mararaba

Application Form
Next of Kin's Information
Full Name: OJOMO MARY Relationship: SISTER
Occupation: STUDENT Mobile Number: 08126462646
Email: Post:
Contact Address: Opposite sec school aso pada mararaba
Parent's / Guardian's Information
Full Name: MISTER PETER OLUWAGBEMINIJA
Residential Address: Opposite sec school aso pada mararaba nasarawa
Referees
Referee Name Referee Address Referee Phone
Oluwagbeminija Samuel AFTER RUTH OKORO,ASO PADA MARARABA 08127161941
MARY OLUWAGBEMINIJA AFTER RUTH OKORO,ASO PADA MARARABA 08101158233

Education Information
Primary Details
School Quali cation From To
Aso Diamond in't Academy PSLC 2006 2012
Secondary Details
School Quali cation From To
Skyward International sec school NECO 2018 2018
Tertiary Details
Institution Course of Study Type From To Classi cation

Application Form
SSCE / NECO / WASSCE / GCE
No. of sittings: Exam Number 1:
Subject Grade Examination
Mathematics B3 GOOD 82329744CF
Economics C6 CREDIT 82329744CF
English C5 CREDIT 82329744CF
Government C5 CREDIT 82329744CF
Civic Education B3 GOOD 82329744CF

Application Form
Have you ever served in the Armed Forces or any other security agency?No
Give details (if Yes):
Reason for leaving::
Do you have any Job Experience Yes
Give details (if Yes):
Reason for leaving::
Have you ever been detained by the Police? No
State reason (if Yes):
Duration of detention:
Have you ever been convicted by a Court of Law? No
State reason (if Yes):
Conviction:
Have you ever travelled out of the country? No
Travel details:
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?:

Application Form
APPLICANT'S DECLARATION
I OJOMO DANIEL, 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
First Name DANIEL Other Name
Religion christianity Marital Status Single
Date Of Birth: Saturday, July 14, 2001 Gender Male
Home Town Mobile Number 08106389742
Height(Meters) 1.65 Email: Ojomodnl@gmail.com
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
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 FORM
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

Applicant's Full Name: OJOMO DANIEL
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, DRRR
Rank:_____________________________________________________
Name:_____________________________________________________
Signature and Date:_____________________________________________________

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Application Form

Application Number: NNR32/2020/OND/1083/0041605

National Identi cation Number: 99283856847

Exam Centre: Nasarawa

Center Location: 177 BN KEFFI

Title: MR Surname: OJOMO

First Name: DANIEL Other Name:

Religion: christianity Marital Status: Single

Gender: Male Date Of Birth: 7/14/2001

State of Origin: ONDO LGA of Origin: Okitipupa

Home Town: Mobile Number: 08106389742

Height(Meters): 1.65 No. of Children:

Hobbies: Cooking,music and reading Email: Ojomodnl@gmail.com

Tattoo/Body Marks: Tribal Marks:

Contact Address Opposite sec school aso pada mararaba

Next of Kin's Information

Full Name: OJOMO MARY Relationship: SISTER

Occupation: STUDENT Mobile Number: 08126462646

Contact Address: Opposite sec school aso pada mararaba

Parent's / Guardian's Information

Full Name: MISTER PETER OLUWAGBEMINIJA

Residential Address: Opposite sec school aso pada mararaba nasarawa

Referee Name Referee Address Referee Phone

Oluwagbeminija Samuel AFTER RUTH OKORO,ASO PADA MARARABA 08127161941

MARY OLUWAGBEMINIJA AFTER RUTH OKORO,ASO PADA MARARABA 08101158233

School Quali cation From To

Aso Diamond in't Academy PSLC 2006 2012

School Quali cation From To

Skyward International sec school NECO 2018 2018

Institution Course of Study Type From To Classi cation

SSCE / NECO / WASSCE / GCE

No. of sittings: Exam Number 1:

Subject Grade Examination

Mathematics B3 GOOD 82329744CF

Economics C6 CREDIT 82329744CF

English C5 CREDIT 82329744CF

Government C5 CREDIT 82329744CF

Civic Education B3 GOOD 82329744CF

Full Name: Force:

Last Rank: Still in service?:

Full Name: Force:

Last Rank: Still in service?:

Application Number: NNR32/2020/OND/1083/0041605

Signature: _______________________________ Date: _______________________________

Certi cation by Parents / Guardian

I _____________________________________ parent/guardian of ______________________________________, who is applying

Parent / Guardian Witness

Name: _________________________________ Name: _________________________________

Address: _______________________________ Address: _______________________________

Signature: _______________________________ Signature: _______________________________

Application Number: NNR32/2020/OND/1083/0041605

Title: MR Surname: OJOMO

First Name DANIEL Other Name

Religion christianity Marital Status Single

Date Of Birth: Saturday, July 14, 2001 Gender Male

State of Origin: ONDO LGA of Origin: Okitipupa

Home Town Mobile Number 08106389742

Height(Meters) 1.65 Email: Ojomodnl@gmail.com

I certify that the applicant ___________________________________ is an indigene of _______________________ L.G.A,

Signature: _ Date: _

I _ parent/guardian of __, who is applying

Name: _ Name: _

Address: _ Address: _

Signature: _ Signature: _

I certify that the applicant _____________ is an indigene of _ L.G.A,

I certify that the applicant ___________ is an indigene of Town,

Surname: __ First Name: