Pro Deo et Patria

Online Application Form

All fields marked with astericks (*) must be filled.
1. First name of Child: *
2. Middle name of Child:
3. Surname of Child: *
4. Date of Birth: *
5. Gender: *
6. Nationality: *
7. State of Origin: *
8. LGA: *
9. Class Applying for: *
10. Religion: *
11. Denomination: *
12. Name and address of Present School: *
13. Name and Phone number of Head Teacher of child's school: *
14. Reason for leaving present school: *
15. Position of responsibility child held at school:
16. List any extra-curricular activities in which child is engaged:
17. Child's Residential Address: *
18. Child is residing with: *
19. Name and Phone number of your minister: *
20. Father's Name: *
21. Mother's Name: *
22. Father's Occupation: *
23. Mother's Occupation: *
24. Father's Phone number: *
25. Mother's Phone number: *
26. Father's email address: *
27. Mother's email address: *
28. Attach a Passport size photograph: *
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